进展型脑梗死患者发生早期神经功能恶化及预后的影响因素分析  

Influencing factors and prognosis of early exacerbation of neurological impairment in patients with progressive cerebral infarction

作　　者：王嘉然 胡洋 WANG Jiaran;HU Yang(Department of Neurology,Kaifeng People's Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]河南省开封市人民医院神经内科,475000

出　　处：《淮海医药》2024年第6期579-582,共4页Journal of Huaihai Medicine

摘　　要：目的:探究进展型脑梗死患者发生早期神经功能恶化(END)及预后的影响因素。方法:回顾性选取2019年1月—2023年6月某院收治的150例进展型脑梗死患者为研究对象,根据是否发生END,分为END组(58例)和NEND组(92例);根据发病30 d后改良Rankin量表(mRs)评分,分为预后良好组(mRS评分<3分,88例)和预后不良组(mRS评分≥3分,62例)。采用单因素、多因素Logistic回归方程分析进展型脑梗死患者发生END及预后的影响因素。结果:单因素分析显示,END组有高血压史、载体动脉狭窄>50%患者比例及美国国立卫生研究院卒中量表(NIHSS)评分、D-二聚体(D-D)水平高于NEND组(P<0.05);预后不良组有高血压史、载体动脉狭窄>50%、发生END患者比例及病灶直径高于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,高血压史(OR=2.210)、NIHSS评分(OR=2.524)、D-D水平(OR=2.303)、载体动脉狭窄>50%(OR=2.614)为进展型脑梗死患者发生END的影响因素(P<0.05);高血压史(OR=2.206)、载体动脉狭窄>50%(OR=2.375)、发生END(OR=2.540)为进展型脑梗死患者预后不良的影响因素(P<0.05)。结论:高血压史、入院时NIHSS评分、D-D水平、载体动脉狭窄>50%为进展型脑梗死发生END的影响因素;而高血压史、载体动脉狭窄>50%、发生END为进展型脑梗死患者预后不良的影响因素。临床应针对性予以干预措施以改善进展型脑梗死患者的临床症状和预后。Objective:To explore the influential factors and prognosis of early exacerbation of neurological impairment(END)in patients with progressive cerebral infarction.Methods:Clinical data of 150 patients with progressive cerebral infarction admitted from January 2019 to June 2023 were included,and the patients were divided into an END group(58 cases)and a non-END group(92 cases).The baseline data,biochemical indexes,imaging examination,neurological function and other data of the END group and the non-END group were compared and analyzed.According to the modified Rankin Scale(mRs)score,the patients were divided into a good prognosis group(mRS Score<3,88 cases)and a poor prognosis group(mRS Score≥3,62 cases),and the independent factors affecting the END of patients with progressive cerebral infarction and the related factors 30 days after the onset of the disease were analyzed.Results:The hypertension history,NIHSS,D-D and carrier artery stenosis>50%levels in the END group were higher than those in the non-END group(P<0.05).The hypertension history,carrier artery stenosis>50%,lesion diameter and END rate after admission in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Multivariate logistic analysis showed that history of hypertension,NIHSS at admission,D-D and carrier artery stenosis>50%were independent risk factors for END in patients with progressive cerebral infarction.History of hypertension,carrier artery stenosis>50%and concurrent END were independent risk factors for adverse prognosis in patients with progressive cerebral infarction.Conclusion:Hypertension,NIHSS score at admission,D-D and carrier artery stenosis are the influential factors of progressive cerebral infarction complicated with END.It is important to take timely intervention measures to improve the clinical symptoms and prognosis of progressive cerebral infarction.

关 键 词：进展型脑梗死 早期神经功能恶化 预后 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]