急性缺血性脑卒中患者出院3年血管源性死亡危险因素分析  

Risk factors for angiogenic death in acute ischemic stroke patients 3 years after discharge

作　　者：邢红梅 张广波 徐丽华 于凯 冀瑞俊[2] Xing Hongmei;Zhang Guangbo;Xu Lihua;Yu Kai;Ji Ruijun(Department of Neuology,Renqiu Kangjixintu Hospital,Renqiu 062550,Hebei Province,China)

机构地区：[1]任丘康济新图医院神经内科,062550 [2]首都医科大学附属北京天坛医院神经病学中心

出　　处：《中华老年心脑血管病杂志》2022年第4期396-399,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省医学科学研究课题(20211275)。

摘　　要：目的 急性缺血性脑卒中(AIS)患者出院3年血管源性死亡危险因素分析。方法 选择老年AIS患者3361例,出院3年血管源性死亡213例(死亡组),非血管源性死亡3148例(非死亡组)。通过患者病史、人口学信息、实验室、影像学检查等资料分析其3年内血管源性死亡的危险因素。结果 死亡组年龄、脑卒中、心房颤动、冠心病、颈动脉狭窄、入院时美国国立卫生研究院卒中量表(NIHSS)评分、白细胞计数、尿素、肌酐、胱抑素C、脂蛋白(a)水平明显高于非死亡组,吸烟、体质量指数、TG和同型半胱氨酸水平明显低于非死亡组(P<0.05,P<0.01)。多因素Cox回归分析显示,年龄(OR=1.401,95%CI:1.362~1.401,P=0.001)、跌倒评分(OR=1.285,95%CI:1.175~1.402,P=0.001)、颈动脉狭窄(OR=1.435,95%CI:1.048~1.926,P=0.025)、入院时NIHSS评分(OR=1.064,95%CI:1.048~1.105,P=0.001)、白细胞计数(OR=1.079,95%CI:1.022~1.112,P=0.005)是血管源性死亡的独立危险因素。生存曲线分析显示,颈动脉狭窄患者死亡风险明显高于无颈动脉狭窄患者,差异有统计学意义(P<0.01)。结论 AIS患者准确全面掌握入院后相关信息,对于评估预后具有重要的临床意义。Objective To analyze the risk factors for angiogenic death in AIS patients 3 years after discharge.Methods A total of 3361 AIS patients were divided into angiogenic death group(n=213) and angiogenic death-free group(n=3148).Their medical history, demographic data, laboratory testing and imaging parameters were recorded.The risk factors for angiogenic death in AIS patients were analyzed.Results The age was significantly older, the incidence of stroke, AF, CHD,carotid artery stenosis, NIHSS score on admission, WBC count and serum levels of urea, creatinine and cystatin C were significantly higher while the history of smoking was significantly shorter, the BMI and serum levels of TG and homocysteine were significantly lower in angiogenic death group than in angiogenic death-free group(P<0.05,P<0.01).Multivariate Cox regression analysis showed that age, fall score, carotid artery stenosis, NIHSS score on admission and WBC count were independent risk factors for angiogenic death in AIS patients(OR=1.401,95%CI:1.362-1.401,P=0.001;OR=1.285,95%CI:1.175-1.402,P=0.001;OR=1.435,95%CI:1.048-1.926,P=0.025;OR=1.064,95%CI:1.048-1.105,P=0.001;OR=1.079,95%CI:1.022-1.112,P=0.005).Survival curve analysis displayed that the risk of angiogenic death was significantly higher in patients with carotid artery stenosis than in those without carotid artery stenosis(P<0.01).Conclusion It is of great clinical significance to grasp the relevant information of AIS patients after admission for assessing their outcomes.

关 键 词：卒中 颈动脉狭窄 白细胞计数 尿素 脂蛋白(A) 死亡原因 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]