老年急性脑卒中患者六个月预后影响因素分析

Analysis of prognostic factors of elderly patients suffering from acute stroke

目的 分析老年急性脑卒中6个月预后情况及影响因素.方法 收集2008年1月至2011年8月重庆市中山医院收治的急性脑卒中老年患者210例的病历资料进行回顾性分析,根据患者6个月时预后分组,通过Logistic回归分析总结影响显示预后的因素.结果 单因素分析结果显示年龄、心脏病史、美国国立卫生研究所脑卒中评分量表（NIHSS）评分、坚持康复治疗、空腹血糖、白蛋白以及收缩压和舒张压是影响老年急性脑卒中患者6个月预后的因素（均P＜0.05）.多因素分析结果显示年龄、NIHSS评分＞7分、空腹血糖＞7.8 mmol/L、收缩压≥140mmHg（1 mmHg=0.133 kPa）和/或舒张压≥90 mm Hg是老年急性脑卒中患者6个月预后的独立危险因素,而白蛋白＞35 g/L是其独立保护因素.结论 老年急性脑卒中发生后年龄过大、NIHSS评分＞7分、空腹血糖＞7.8 mmol/L、收缩压≥140 mm Hg和/或舒张压≥90 mm Hg往往提示预后不良,而白蛋白＞35 g/L提示预后可能较好,可以通过坚持康复训练改善预后.

Objective To analyze of the six months prognosis and the related factors in elderly patients suffering from acute stroke.Methods Totally 210 acute stroke patients were selected from January 2008 to August 2011,and divided into two groups according to the prognosis.The related influential factors were analyzed by Logistic regression analysis.Results The results of univariate analysis showed that age,history of heart disease,U.S.national institutes of health stroke score scale （NIHSS） score,adhere to rehabilitation treatment,fasting plasma glucose（FPG）,albumin ALB,systolic pressure（SBP） and diastolic blood pressure （DBP） were the prognostic factors in elderly patients suffering from acute stroke （all P 〈 0.05）.Moreover,the results of Multivariate analysis showed that age,NIHSS score 〉 7,FPG 〉 7.8 mmol/L,SBP ≥ 140 mm Hg and （or） DBP ≥ 90 mm Hg were independent risk factors for the prognosis.However,ALB 〉 35 g/L was an independent protective factor.Conclusion Old age,NIHSS score 〉 7,FPG 〉 7.8 mmol/L,the SBP≥ 140 mm Hg and （or） DBP ≥90 mm Hg often indicate the poor prognosis,while ALB 〉 35 g/L suggests the better prognosis in elderly patients suffering from acute stroke.