脑干梗死的危险因素分析

Risk factors analysis of brainstem infarction

目的探讨脑干梗死的危险因素。方法根据脑梗死部位将193例脑梗死患者分为大脑半球梗死组(128例)和脑干梗死组(65例),比较两组间性别、年龄、吸烟、合并症、血脂及糖化血红蛋白(HbA1c)水平,以及两组患者基底动脉和椎动脉狭窄度、基底动脉弯曲分级、椎动脉优势的比率;采用Logistic回归方法分析脑干梗死危险因素。结果与大脑半球梗死组比较,脑干梗死组年龄明显降低,吸烟、合并糖尿病的比率明显增高,血低密度脂蛋白及HbA1c水平明显增高(P<0.05～0.01);基底动脉和椎动脉狭窄率、基底动脉弯曲≥2级率及椎动脉优势比率明显增高(P<0.05～0.01)。Logistic多因素回归分析显示,伴有糖尿病(OR=4.018,95%CI:1.796～8.992;P=0.0006)、基底动脉狭窄(OR=1.003,95%CI:1.018～1.048;P<0.0001)和基底动脉弯曲≥2级(OR=1.377,95%CI:1.008～1.059;P=0.0087)与脑干梗死的发生独立相关。结论伴有糖尿病、基底动脉狭窄和基底动脉弯曲度是脑干梗死的重要的高危因素。

Objective To investigate the risk factors of brainstem infarction.Methods According to the region of cerebral infarct（CI） lesion,the 193 CI patients were divided into cerebral hemisphere infarct group（128 cases） and brainstem infarct group（65 cases）.The gender,age,smoking,complications,the levels of blood lipid and glycated hemoglobin（HbA1c）,the degree of basal artery and vertebral artery stenosis,the incidence of basal artery bending classification,vertebral artery advantage between the two groups were compared.The risk factors of brainstem infarction were analyzed by Logistic regression analysis.Results Compared with cerebral hemisphere infarction group,the age in brainstem infarct group was significant lower,the rates of smoking and combined diabetic were significant higher,the levels of low density lipoprotein cholesterol and HbA1c were significantly increased（P〈0.05-0.01）;the stenosis rates of basal artery and vertebral artery,the incidences of basal artery bending degree≥2 and vertebral artery advantage were significant higher（P〈0.05-0.01）.Logistic multiple factors regression analysis showed that the patients with diabetes（OR=4.018,95%CI：1.796-8.992;P=0.0006）,basal artery stenosis（OR=1.003,95%CI：1.018-1.048;P〈0.0001）,basal artery bending degree≥2（OR=1.377,95%CI： 1.008-1.059;P=0.0087）were independent correlation with brainstem infarction.Conclusion With diabetic,basilar artery stenosis and basilar artery bending score ≥2 were important risk factors of brainstem infarction.