老年动脉粥样硬化型脑梗死复发的危险因素分析  

Risk factors for recurrent atherosclerotic ischemic stroke in the elderly

作　　者：黄超 董斌 席春华 HUANG Chao;DONG Bin;XI Chunhua(Department of Neurology,the Third Affiliated Hospital of Anhui Medical University,Anhui Province,Hefei230061,China)

机构地区：[1]安徽医科大学第三附属医院神经内科,安徽合肥230061

出　　处：《中国当代医药》2023年第19期57-60,共4页China Modern Medicine

基　　金：安徽医科大学校科研基金立项资助项目(2020xkj237)。

摘　　要：目的研究老年动脉粥样硬化型脑梗死患者复发的危险因素。方法选取2020年9月至2022年6月安徽医科大学第三附属医院复发性脑梗死患者20例为复发组,收集同时期住院治疗的老年首发脑梗死患者30例作为对照组,比较两组的临床资料与血清学指标。结果单因素分析显示两组间糖尿病、高尿酸血症、同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)、活化部分凝血活酶时间(APTT)、白蛋白与球蛋白比值(A/G)比较,差异有统计学意义(P<0.05),多因素logistic回归分析显示APTT(OR=0.794)、A/G(OR=0.134)是脑梗死复发的独立影响因素(P<0.05),APTT和A/G联合预测的AUC为0.831(P<0.05),最大约登指数为0.556,此时灵敏度为66.7%,特异度为88.9%。结论APTT和A/G是老年动脉粥样硬化型脑梗死复发的独立影响因素,两组联合可用于脑梗死复发风险的预测,临床需针对危险因素APTT和A/G进行早期干预,积极预防脑梗死的复发。Objective To study the risk factors of relapse in elderly patients with atherosclerotic ischemic stroke.Method A total of 20 patients with recurrent cerebral infarction in the Third Affiliated Hospital of Anhui Medical University from September 2020 to June 2022 were selected as the recurrent group,and 30 patients with first-episode cerebral infarction who were hospitalized during the same period were selected as the control group.The clinical data and serological indexes of the two groups were compared.Results Univariate analysis showed that there were statistically significant differences in diabetes,hyperuricemia,homocysteine(Hcy),glycosylated hemoglobin(HbA1c),activated partial thromboplastin time(APTT)and albumin to globulin ratio(A/G)between the two groups(P<0.05).Multivariate logistic regression analysis showed that APTT(OR=0.794)and A/G(OR=0.134)were independent influencing factors for cerebral infarction recurrence(P<0.05),The AUC predicted by APTT and A/G was 0.831(P<0.05),the maximum approximate entry index was 0.556,and the sensitivity was 66.7%.The specificity is 88.9%.Conclusion APTT and A/G are independent factors of recurrence of cerebral infarction in elderly patients with atherosclerosis,and the combination of the two groups can be used to predict the recurrence of cerebral infarction.Early intervention for APTT and A/G risk factors is needed to prevent the recurrence of cerebral infarction.

关 键 词：老年 动脉粥样硬化型 脑梗死 活化部分凝血活酶时间 白蛋白与球蛋白比值 

分 类 号：R743.32[医药卫生—神经病学与精神病学] R743.1[医药卫生—临床医学]