急性脑梗死患者短期预后影响因素的logistic回归分析

Influential factors for short-term prognosis of patients with acute cerebral infarction:a logistic regression analysis

目的探讨急性脑梗死患者短期预后的影响因素,为临床诊治提供依据。方法对广东省中医院脑血管病中心2005-08-01至2008-07-31连续3年共1337例出院的脑梗死患者进行回顾性研究(www.clinicaltrias.gov注册ID号:NCT00966316),收集可能与患者病情相关的指标,进行单因素方差分析,初步筛选其中有统计学意义的指标,并进一步采用logistic回归筛选影响急性脑梗死1个月内预后的独立危险因素。结果 1337例患者中,好转1023人,未好转314人,共收集可能影响患者预后的指标34个(涉及人口学特征、入院时病情严重程度、既往病史和并发症),经单因素分析初步提取有统计学意义的指标共7个,进入logistic回归模型,最终筛选出2个独立危险因素,分别是进展性卒中(OR=0.20,95%CI 0.12～0.33)和泌尿系感染(OR=0.38,95%CI 0.22～0.66)。结论积极防治进展性卒中和泌尿系统感染可能是改善急性脑梗死患者短期预后的重要环节。

Objective To screen the risk factors influencing the short-term prognosis of patients with acute cerebral infarction（ACI）,with an attempt to provide clues for improving early diagnosis and treatment.Methods The clinical data of 1337 patients with ACI,who had been hospitalized in the Department of Neurology of Guangdong Provincial Hospital of Traditional Chinese Medicine enrolled from August 1st,2005 to July 31st,2008,were retrospectively analyzed.Factors which would likely influence the outcome of ACI were collected,and those which showed statistical significance by One-Way ANOVA analysis were screened,followed by further logistic regression analysis to obtain the independent risk factors which were related to 1-month outcome of these patients.Results Among the 1337 patients,a favorable outcome was found in 1023 patients,and in 314 patients there was no obvious improvement.A total of 34 factors which might influence the outcome of ACI patients,including demographic features,severity of disease at admission,medical history and complications,were collected.The logistic regression analysis finally showed 2 factors,i.e.progressive stroke（OR=0.20,95%CI 0.120.33） and urinary tract infection（OR=0.38,95%CI 0.220.66）,were the independent risk factors,out of 7 factors which showed statistical significance in One-Way ANOVA analysis（www.clinicaltrial.gov ID： NCT00966316）.Conclusion Prevention of progressive stroke and urinary tract infection might be the key for improvement of one-month outcome in ACI patients.