进展性缺血性卒中的危险因素分析

Analysis of Risk Factors for Progressive Ischemic Stroke

目的:探讨进展性缺血性卒中的危险因素,为其预防提供依据。方法:回顾性分析2002年8月—2004年8月收治的166例进展性缺血性卒中病例,并以同期住院的65例非进展性缺血性卒中患者作为对照组。对两组患者的年龄、性别、血脂水平、血纤维蛋白原水平、血糖水平、发热、白细胞增多、平均动脉压、糖尿病史和CT早期梗死征象进行比较。结果:进展组患者的糖尿病史(P<0.05)、CT早期梗死征象(P<0.05)、发热(P<0.01)和白细胞增多(P<0.001)的比例显著较高,血糖(P<0.05)和纤维蛋白原(P<0.05)水平明显高于对照组;多变量logistic回归分析表明,糖尿病史(P=0.029)、发热(P=0.0146)、白细胞增多(P=0.005)和CT早期梗死征象(P=0.0027)是缺血性卒中早期病情加重的独立预测因素。结论:糖尿病史、发热、白细胞增多和CT早期梗死征象是进展性缺血性卒中的独立危险因素。

Objectives： To explore the risk factors of progressive ischemic stroke and to provide bases for its prevention. Methods： From August 2002 to August 2004, 166 patients with progressive ischemic stroke were analyzed retrospectively and 65 patients with non-progressive ischemic stroke were enrolled as the control group. Their ages, sexes, the levels of lipid, fibrinogen and blood glucose, fever, leukocytosis, mean arterial pressure, diabetes history and signs of early cerebral infarction on CT were compared. Results： The proportions of diabetes history （P 〈 0. 05）, signs of early cerebral infarction on CT （P 〈 0. 05）, fever （P 〈 0.01 ） and leukocytosis （P 〈 0. 001 ） were significantly higher in the progressive group. The multivariable logistic regression analysis showed that the independent predictive factors of early exacerbation of ischemic stroke were diabetes history （P =0. 029）, fever （P =0. 014 6）, leukocytosis （P =0. 005） and signs of early cerebral infarction on CT （P =0. 002 7）. Conclusion： The independent risk factors of ischemic progressive stroke are the diabetes history, fever, leukocytosis and signs of early cerebral infarction on CT.