大动脉粥样硬化狭窄性脑梗死的危险因素

Risk factors of ischemic cerebral infarction with large-artery atherosclerotic stenosis

目的研究大动脉粥样硬化狭窄性脑梗死的危险因素。方法186例脑梗死患者根据大动脉狭窄情况分为狭窄组（124例）及无狭窄组（62例）。收集患者的临床资料，检测其血同型半胱氨酸（Hcy）及血脂水平。采用Essen卒中风险评分量表（ESRS）对患者进行评分。采用多元Logistic回归分析大动脉狭窄性脑梗死的相关因素。结果狭窄组有高血压、高Hcy血症、高血压伴高Hcy血症及ESRS评分高危的比率均显著高于无狭窄组（均P〈0．05）。多元Logistic回归分析显示，ESRS评分高危及高血压伴高Hcy血症是大动脉狭窄性脑梗死的独立危险因素（Wald值8．60、5．73；P〈0．05～0．005）。结论ESRS评分高危、高血压伴高Hcy血症是大动脉粥样硬化狭窄性脑梗死的独立危险因素。

Objective To investigate the risk factors of ischemic cerebral infarction with large-artery atherosclerotic stenosis. Methods According to the large-artery stenosis, 186 patients with ischemic cerebral infarction were divided into stenosis group （124 cases） and non-stenosis group （62 cases）. The clinical data were collected, and the levels of homocysteine and blood lipid were detected. Essen stroke risk score （ESRS） was assessed. The related factors of ischemic cerebral stroke were analyzed by Logistic regression analysis. Results The rate of hypertension, hyperhomocysteinemia （HHcy）, hypertension accompanied with hyperhomocysteinemia and high risk by ESRS score in stenosis group were significantly higher than those in non-stenosis group （ all P 〈 0. 05 ）. Logistic regression analysis showed that high risk by ESRS score and hypertension accompanied with homocystinemia were independent risk factors for ischemic cerebral infarction with large-artery atherosclerotic stenosis （ Wald = 8.60, 5.73;P 〈 0. 05 -0. 005 ）. Conclusion High risk by ESRS score and hypertension accompanied with HHcy are independent risk factors for ischemic cerebral infarction with large-artery atherosclerotic stenosis.