进展性缺血性脑卒中预后影响因素分析

The analysis of the factors influencing the prognosis of progressive ischemic stroke

目的探讨进展性缺血性脑卒中预后影响因素。方法86例诊断为进展性缺血性脑卒中的患者,依其抗血小板聚集,扩容等一般性治疗后MRS(改良的Rankin量表)评分分为预后好和预后差(含死亡者)两组。记录患者的9个参数:性别、年龄、血糖情况、体温、NIHSS评分、头颅MRI影象学改变、医源性原因、脑动脉狭窄与否和是否连用低分子肝素钙。用单变量logistic回归分析得出与进展性缺血性脑卒中预后显著相关的变量,后用多变量stepwiselogistic回归分析得出预后的最佳回归方程。结果logistic回归分析表明与进展性缺血性脑卒中预后显著相关的独立变量包括:血糖、体温、NIHSS评分、脑动脉狭窄与否、是否用低分子肝素钙和头颅MRI影象学改变。结论本研究显示进展性缺血性脑卒中的预后和血糖、体温、NIHSS评分、脑动脉狭窄与否、是否用低分子肝素钙和头颅MRI影象学改变关系密切。

Objective To explore the factors that influence the prognosis of progressive ischemic stroke. Methods We studied 86 progressive ischemic stroke patients, according to the inital MRS they were devide into the good prognosis and the bad prognosis（including the death） after the general theropy with anti-platelet aggregation and recorded 9 parameters in patients： gender,age,glucose ,fever, inital NIHSS,the imaging of MRI,iatrogenic reasons,the narrow artery and the use of low-molecular-weight heparin calcium.To get the obviously variability with the prognosis of progressive ischemic stroke by single variable logistic regression analysis. To get the best equation by multivariable stepwise logistic regression analysis . Results the obviously variability with the prognosis of progressive ischemic stroke is glucose,fever,initial NIHSS,the imaging of MRI,iatrogenic reason,the narrow artery,the use of low-molecular-weight heparin calcium.Conclusion This study has discovered that the prognosis of progressive ischemic stroke had intimate relationship with glucose,fever,initial NIHSS,the imaging of MRI,iatrogenic reason,the narrow artery.the use of low-molecular-weight heparin calcium.