缺血性脑卒中患者微栓子检出影响因素分析  

Analysis of influencing factors of microemboli detection in patients with ischemic stroke

作　　者：吴冬生 齐向征[1] 孔宁[2] WU Dongsheng;QI Xiangzheng;KONG Ning(Jiyuan People's Hospital,Jiyuan,Henan459000,China)

机构地区：[1]济源市人民医院全科医学科,河南济源459000 [2]济源市人民医院神经内一科,河南济源459000

出　　处：《社区医学杂志》2023年第22期1158-1162,共5页Journal Of Community Medicine

摘　　要：目的分析缺血性脑卒中患者微栓子信号(MES)检出的影响因素,以便为提高MES的预测效能提供参考。方法采取整群抽样法选取2019-02-03-2022-01-04济源市人民医院接受治疗的行MES监测的缺血性脑卒中患者323例进行回顾性分析。收集患者一般资料、实验室检查指标、颈动脉狭窄程度及MES检出情况等资料。根据MES检出情况将患者分为检出组(n=67)与未检出组(n=256),比较2组患者各参数,并采用多因素分析判断EMS阳性率与各因素分关系。结果本研究的323例缺血性脑卒中患者中有67例(20.74%)检出MES。多因素二元logistic回归分析结果显示有高血压史(OR=6.828,95%CI为2.974~15.675)、平均血小板体积>正常值(OR=5.534,95%CI为3.032~10.102)、低密度脂蛋白胆固醇>正常值(OR=4.212,95%CI为2.886~6.149)、重度颈动脉狭窄(OR=7.668,95%CI为3.162~18.596)及完全/部分前循环梗死(OR=1.598,95%CI为1.112~2.297)为缺血性脑卒中患者MES检出危险因素,差异有统计学意义,均P<0.05。结论缺血性脑卒中患者MES检出率较高,微栓子检出率主要与高血压、平均血小板体积、低密度脂蛋白胆固醇,颈动脉狭窄程度及牛津郡社区卒中项目分型(OCSP)有关。Objective To analyze the influencing factors of detecting microemboli signal(MES)in patients with ischemic stroke,in order to provide a reference for improving the predictive efficacy of MES.Methods A cluster sampling method was used to select 323patients with ischemic stroke who received MES monitoring in Jiyuan People's Hospital from February 3,2019to January 4,2022for retrospective analysis.We collected the patient's general data,laboratory examination indexes,carotid artery stenosis degree and MES detection status and other data.According to the detection of MES,the patients were divided into the detected group(n=67)and the undetected group(n=256).The parameters of the two groups were compared,and the relationship between the positive rate of EMS and each other factor score was analyzed by multi-factor analysis.Results Of the 323patients with ischemic stroke in this study,67(20.74%)had MES.Binary Logistic regression analysis showed a history of hypertension(OR=6.828,95%CI:2.974-15.675),average platelet volume>normal(OR=5.534,95%CI:3.032-10.102),low-density lipoprotein cholesterol>normal(OR=4.212,95%CI:2.886-6.149),severe carotid artery stenosis(OR=7.668,95%CI:3.162-18.596)and complete/partial anterior circulation infarction(OR=1.598,95%CI:1.112-2.297)were risk factors for MES detection in patients with ischemic stroke,and the difference was statistically significant(all P<0.05).Conclusions The detection rate of MES was high in patients with ischemic stroke.The detection rate of microemboli was mainly related to hypertension,mean platelet volume,low-density lipoprotein cholesterol,carotid stenosis and oxfordshire community stroke project classification(OCSP).

关 键 词：缺血性脑卒中 微栓子 多因素分析 LOGISTIC回归 

分 类 号：R743.31[医药卫生—神经病学与精神病学]