急性脑卒中患者预后相关因素分析

Analysis of prognosis factors for acute stroke patients

目的探讨影响急性脑卒后患者预后的因素。方法选取广州市5家三级甲等医院神经内科自2014年5月至2014年8月收治的551例急性脑卒中（脑梗死或脑出血）患者，收集患者的临床资料并随访发病后3个月的预后情况，Logistic回归分析影响脑卒中患者预后的因素。结果本组患者预后良好311例（56．4％1，预后不良240例（43．6％1。预后良好组、预后不良组患者的年龄、文化程度、照顾者、体温、美国国立卫生研究院卒中量表评分（NIHSS）和日常生活活动能力量表（BI）评分、在院时间、卒中次数、吞咽困难、尿失禁、冠心病、吸烟者比例、总胆固醇（Tc）水平不同，差异有统计学意义（P〈0．05），Logistic回归分析显示影响脑卒中预后的独立危险因素为年龄、体温、NIHSS和BI评分、在院时间、脑卒中次数、尿失禁。结论年龄≥60岁、体温〉37℃、NIHSS评分高、日常生活不能自理、在院时间长、多次脑卒中以及脑卒中后尿失禁的脑卒中患者预后不良，应有针对性的早期开展科学干预，以提高患者生存质量。

Objective To analyze the risk factors associated with prognosis of stroke patients. Methods A total of 551 stroke patients from 5 third class A hospital in Guangzhou from May 2014 to August 2014, were recruited. The clinical data and prognosis 3 months after follow up of these patients were collected and Logistic regression analysis was used to analyze the influencing factors of stroke prognosis. Results Good prognosis was noted in 311 patients （56.4%） and bad one was noted in 240 patients （43.6%）; age, education degree, watcher, temperature, NIHSS and Barthel index （BI） scores, hospital stays, stroke frequency, dysphagia, urinary incontinence, coronary heart disease, smoking history and total cholesterol levels between patients with good or bad prognosis were significantly different （P〈 0.05）. Logistic regression analysis showed that major factors for stroke prognosis included age, temperature, NIHSS and BI scores, hospital stays, stroke frequency and urinary incontinence. Conclusions Patients with age ≥ 60 years, temperature〉37℃, high NIHSS scores, serious defects of activities of daily living, long hospital stays, recurrent stroke, post-stroke urinary incontinence trend to have poor prognosis, therefore, these patients should be targeted to plan intervention program to improve the life quality.