影响急性脑梗死患者治疗效果的相关因素分析

Related factors of influence curative effects in patients with acute cerebral infarction

目的探讨影响急性脑梗死患者治疗效果的相关因素。方法对360例急性脑梗死患者予以卒中单元规范化治疗;在治疗前、治疗14 d时进行美国国立卫生研究院卒中量表(NIHSS)评分,以及检测有关血常规、生化指标。采用多因素Logistic回归分析对与患者治疗后NIHSS评分相关的指标进行分析。结果与治疗前比较,脑梗死各亚组的血浆脂蛋白[Lp(a)]、尿酸、D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)水平明显降低;轻、中度亚组血糖及中、重度亚组直接胆红素水平明显降低;中度亚组三酰甘油、低密度脂蛋白(LDL)及重度亚组总胆红素水平明显降低(均P<0.05)。重度亚组治疗前的血同型半胱氨酸(Hcy)水平明显高于轻、中度亚组(均P<0.05)。多因素Logistic回归分析显示,治疗后NIHSS评分与血糖、hs-CRP、Hcy、尿酸、D-D、LDL、Lp(a)水平相关(OR=1.235～4.042,P<0.05～0.001)。结论血糖、hs-CRP、Hcy、尿酸、D-D、LDL和Lp(a)为影响急性脑梗死患者治疗效果的相关因素。

Objective To explore the related factors of influence curative effects in patients with acute cerebral infarction（ACI）. Methods Three hundred and sixty cases of ACI patients were given standardized treatment in stroke unit. The patients were scored with United States National Institutes of Health Stroke Scale （ NIHSS ） , and blood routine, biochemical indexes were measured before and 14 d after treatment. The related indexes with NIHSS scores after treatment were analyzed by logistic regression analysis. Results Compared with before treatment, the level of Lipoprotein（a） [ LP（a） ~, uric acid（ UA）, two D-dimer （ D-D）, high sensitive C reactive protein （hs-CRP） were significantly decreased in each ACI subgroup; blood glucose in light, moderate subgroups and direct bilirubin in moderate, severe subgroups were significantly decreased （ all P 〈 0.05 ）. The blood homocysteine （Hcy） levels in severe subgroup before treatment were significantly higher than that in light, moderate subgroups （ all P 〈 0. 05 ）. The multivariate logistic regression analysis showed that NIHSS score after intervention treatment related with levels of blood glucose, hs-CRP, Hcy, UA, D-D, LDL and Lp （a） （ OR = 1. 235 - 4. 042,P 〈 0. 05 - 0. 001 ）. Conclusion The blood glucose, hs-CRP, Hcy, UA, D-D, LDL and Lp（a） are related factors to influence the curative effects of ACI patients.