后循环脑梗死的危险因素及预后影响因素分析

ANALYSIS OF RISK FACTORS AND PROGNOSIS IN PATIENTS WITH POSTERIOR CIRCULATION ISCHEMIC STROKE

目的探讨后循环脑梗死的危险因素及预后影响因素。方法回顾性分析2011年3月—2013年12月在唐山市工人医院神经内科收治的急性脑梗死患者,用Excel表格收集急性脑梗死的发病危险因素及可能影响预后的相关因素,包括年龄、性别、高血压、高血脂、糖代谢异常等资料。统计循环脑梗死和后循环脑梗死患者的例数,采用统计学软件分析后循环脑梗死的危险因素。病后3个月复查时,采用改良Rankin量表(mRS)对患者预后进行评估,mRS评分≤2分为预后良好,mRS>2分为预后不良。统计预后良好组和预后不良组的例数,采用统计学软件分析后循环脑梗死的预后影响因素。结果 Logistic回归分析结果显示,与发生后循环梗死相关的危险因素有3项:高同型半胱氨酸血症、房颤、既往TIA史。3个月复查时,预后良好56例(65.1%),预后不良30例(34.9%)。经过Logistic回归分析,与后循环脑梗死静脉溶栓后患者近期预后不良相关的因素有4项:入院时NIHSS评分>12、发病至溶栓时间>4.5 h、高同型半胱氨酸血症、24h后抗血小板。结论对于后循环梗死患者,尽早溶栓且溶栓后及时进行抗凝治疗对改善近期预后有一定意义。

Objective To analyze the risk factors and prognosis in patients with posterior circulation ischemic stroke.Methods Using a retrospective study methods,the patients with acute cerebral infarction from March 2011 to December 2013 in the department of neurology,Tangshan Gongren Hospital were admitted in this study,onset of acute cerebral infarction risk factors and possible related factors affecting the prognosis were collected by using excel spreadsheet,including age,sex,hypertension,hyperlipidemia,sugar metabolic abnormalities and other information.The number of circulation after cerebral infarction and cerebral infarction cases was recorded,and then posterior circulation cerebral infarction risk factors were analyzed by using statistical software.After intravenous thrombolysis,3 months after illness,the modified Rankin scale（mRS）was used to evaluate the prognosis of patients,mRS score≤ 2 was divided into good prognosis,mRS〉 2 was divided into poor prognosis.Results Logistic regression analysis results showed that there were 3items of risk factors associated with posterior circulation infarction：homocysteine hematic disease,atrial fibrillation,history of TIA.56 patients（65.1%）were good prognosis and 30 patients（34.9%）of poor prognosis 3 months after treatment.There were four factors that ralated with posterior circulation cerebral infarction after intravenous thrombolysis in patients with recent prognosis：NIHSS score〉 12,thrombolysis time〉 4.5h,high homocysteine levels,platelet after 24 h.Conclusion For patients with posterior circulation infarction,thrombolysis and as soon as possible after thrombolysis in a timely manner of anticoagulant therapy has a certain significance for improving the prognosis of recent.