缺血性脑卒中患者早期神经功能恶化的危险因素研究

Risk Factors of Early Neurological Deterioration in Patients with Ischemic Stroke

目的探讨缺血性脑卒中患者早期神经功能恶化的危险因素。方法选择彭州市人民医院2010年8月—2013年12月收治的缺血性脑卒中患者96例,回顾性分析其临床资料,分析早期神经功能恶化的危险因素。结果96例患者中发生早期神经功能恶化27例(病例组),未发生早期神经功能恶化69例(对照组),早期神经功能恶化发生率为28.1%。单因素分析结果显示,病例组患者高血压、糖尿病、高脂血症、心房纤颤、颈动脉狭窄发生率,白细胞计数,C反应蛋白、D-二聚体水平,美国国立卫生研究院卒中量表(NIHSS)评分高于对照组,凝血酶原时间长于对照组(P<0.05)。多因素Logistic回归分析结果显示,高血压〔OR=2.171,95%CI(1.080,4.361)〕、糖尿病〔OR=3.842,95%CI(1.638,9.012)〕、心房纤颤〔OR=6.573,95%CI(1.073,40.286)〕为缺血性脑卒中患者早期神经功能恶化的危险因素(P<0.05)。结论缺血性脑卒中患者早期神经功能恶化发生率较高,高血压、糖尿病、心房纤颤是其危险因素。

Objective To explore the risk factors of early neurological deterioration in patients with ischemic stroke. Methods A total of 96 patients with ischemic stroke were selected in the People′s Hospital of Pengzhou from August 2009 to December 2013,and their clinical data was retrospectively analyzed to explore the risk factors of early neurological deterioration. Results Of the 96 patients,27 cases occurred early neurological deterioration （ case group ）,69 cases did not （ control group）,the incidence was 28. 1%. Univariate analysis showed that,the incidence of hypertension,diabetes,hyperlipidaemia, atrial fibrillation and carotid artery stenosis,white blood cell count,C reactive protein and D-dimer levels,NIHSS score of case group was statistically significantly higher than that of control group,respectively,while the prothrombin time was longer （P〈0. 05）. Multivariate Logistic regression analysis showed that,hypertension〔OR=2. 171,95%CI（1. 080,4. 361）〕, diabetes〔OR=3. 842,95%CI（1. 638,9. 012）〕,atrial fibrillation〔OR=6. 573,95%CI（1. 073,40. 286）〕were risk factors of early neurological deterioration in patients with ischemic stroke. Conclusion The incidence of early neurological deterioration in patients with ischemic is relatively high,hypertension,diabetes and atrial fibrillation are the risk factors.