急性脑梗死病情进展的危险因素及证候要素分析  

An analysis of risk factors and syndrome elements in the progress of acute cerebral infarction

作　　者：马琳琳 张彬[2] MA Linlin

机构地区：[1]山东中医药大学,山东济南250355 [2]淄博市中医医院,山东淄博255300

出　　处：《中医临床研究》2022年第26期52-55,共4页Clinical Journal Of Chinese Medicine

基　　金：山东省齐鲁卫生与健康领军人才培育工程项目(鲁卫人才字[2020]3号);天麻钩藤饮化裁方治疗超静脉溶栓时间窗轻型卒中的临床研究(2021Z027)。

摘　　要：目的:探讨与急性脑梗死病情进展相关的危险因素及证候要素,为临床早期制定干预方案提供依据。方法:选择2019年10月-2020年9月淄博市中医医院脑病科收治的281例急性脑梗死患者,根据发病7天内病情是否进展分为进展组(92例)和非进展组(189例)。回顾性分析两组患者的相关临床资料,对单因素分析有统计学意义的因素进行多因素Logistic回归分析,筛选出独立危险因素。结果:两组在纤维蛋白原、D-二聚体、入院血糖、同型半胱氨酸、糖尿病史、入院时间、是否溶栓治疗方面的差异有统计学意义(P<0.05),是病情进展的危险因素,纤维蛋白原升高、高同型半胱氨酸、高血糖是其独立危险因素。内风是脑梗死病情进展的主要证候要素。结论:血液高凝状态、高血糖、高同型半胱氨酸、超过24 h入院及非溶栓治疗的急性脑梗死患者病情进展的风险大,内风是其主要的证候要素,早期进行中西医干预尤为重要。Objective:To explore the risk factors and syndrome elements related to the progress of acute cerebral infarction in order to provide more evidence for the early clinical intervention.Methods:A total of 281 cases from October 2019 to September 2020 were divided into the progressive group(92 cases)and the non-progressive group(189 cases)according to whether the disease condition progressed within 7 days of onset.The relevant clinical data of patients in the two groups was retrospectively analyzed.The multivariate logistic regression analysis was performed on factors that were statistically significant in univariate analysis,and independent risk factors were screened out.Results:The differences between the two groups in fibrinogen,D-dimer,hospitalized blood glucose,homocysteine,diabetes history,hospital admission time,and thrombotic treatment were statistically significant(P<0.05),which were risk factors for the progression of the disease,and elevated fibrinogen,high homocysteine and high blood glucose were the independent risk factors.The internal wind is the main factor of the progression of cerebral infarction.Conclusion:Acute cerebral infarction patient with hypercoagulable state,hyperglycemia,hyperhomocysteine,hospital admission for more than 24 hours,and non-thrombotic therapy are at high risk of disease progression,and internal wind is the main syndrome element.Early intervention in TCM and Western medicine is particularly important.

关 键 词：急性脑梗死 病情进展 危险因素 证候要素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]