急性大动脉粥样硬化型脑梗死早期神经功能恶化的影响因素  

Factors Influencing Early Neurological Deterioration in Acute Large Artery Atherosclerotic Stroke

作　　者：王涛[1] 刘惠芳[1] 陈晓华[2] WANG Tao;LIU Huifang;CHEN Xiaohua(Department of Neurology,Affiliated Hospital of Yan'an University,Yan'an Shaanxi 716000)

机构地区：[1]延安大学附属医院神经内科,陕西延安716000 [2]韩城市人民医院神经内科,陕西韩城715400

出　　处：《医学临床研究》2023年第11期1653-1655,1659,共4页Journal of Clinical Research

摘　　要：【目的】探讨急性大动脉粥样硬化型(LAA)脑梗死早期神经功能恶化(END)的影响因素。【方法】两院收治的194例急性LAA脑梗死患者,根据在院期间是否发生END分为END组(n=68)及非END组(n=126)。比较两组患者临床资料及实验室相关检查指标,采用多因素Logistic回归分析END的影响因素,采用受试者工作特征(ROC)曲线评估临床指标预测END的价值。【结果】END组患者收缩压、舒张压及入院时美国国立卫生院脑卒中量表(NIHSS)评分均显著高于非END组(P<0.05);END组低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)及同型半胱氨酸(Hcy)水平显著高于非END组(P<0.05);多因素Logistic回归分析显示:入院时NIHSS评分、Hcy、收缩压及HbA1c与END呈相关性,其优势比(OR)分别为3.22、1.03、1.08及1.83;ROC提示入院时NIHSS评分、Hcy、收缩压及HbA1c预测END的曲线下面积(AUC)分别为0.89、0.76、0.71及0.81。【结论】影响急性LAA脑梗死END的危险因素为入院时NIHSS评分、Hcy、收缩压及HbA1c,且上述因素可预测END。【Objective】To investigate the factors influencing early neurological deterioration(END)in acute large artery atherosclerotic(LAA)stroke.【Methods】A total of 194 LAA stroke patients admitted to the two hospitals were enrolled in the study.Based on whether END occurred during hospitalization,patients were divided into the END group(n=68)and the non-END group(n=126).Clinical data and relevant laboratory test indicators of both groups were compared between the two groups.Multivariate logistic regression was used to analyze the factors related to END,and the receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of clinical indicators for END.【Results】The systolic and diastolic blood pressures as well as the National Institutes of Health Stroke Scale(NIHSS)scores upon admission in the END group were significantly higher than those in the non-END group(P<0.05).The low-density lipoprotein cholesterol(LDL-C),glycated hemoglobin(HbA1c),and homocysteine(Hcy)levels in the END group were significantly higher than those in the non-END group(P<0.05).Multivariate logistic regression analysis showed that the NIHSS score upon admission,Hcy,systolic pressure,and HbA1c were correlated with END.Their odds ratios(OR)were 3.22,1.03,1.08 and 1.83,respectively.ROC analysis indicated that the predictive value areas under the curve(AUC)for the NIHSS score upon admission,Hcy,systolic pressure,and HbA1c for END were 0.89,0.76,0.71,and 0.81,respectively.【Conclusion】Factors influencing END in acute LAA stroke include the NIHSS score upon admission,Hcy,systolic pressure,and HbA1c.These factors possess predictive value for END.

关 键 词：脑梗死 急性病 创伤 神经系统 影响因素分析 

分 类 号：R743.33[医药卫生—神经病学与精神病学]