老年大脑中动脉闭塞患者远期预后相关危险因素分析

Related Risk Factors of Long- term Prognosis in Elderly Patients with Middle Cerebral Artery Occlusion

目的分析影响老年大脑中动脉闭塞（middle cerebral artery occlusion，MCAO）患者远期预后的相关危险因素。方法回顾性收集2006年1月～2013年12月期间，在笔者医院神经内科住院，行头颈部cT血管成像（CTangiography，CTA）或磁共振血管成像（magnetic resonance angiography，MRA）证实存在MCAO的所有老年（年龄≥65岁）患者。收集患者住院期间临床资料及生化指标，并对其进行远期随访。以死亡或脑卒中再发为临床终点事件，采用单因素及多因素Logistic回归分析影响远期预后的因素。结果59例MCAO老年患者，失访9例（15．25％），其余50例患者平均随访时间为53．02（6～97）个月，其中死亡19例（38％），脑卒中再发5例（10％）。单因素及多因素分析显示吸烟史、白蛋白水平及高血压病史与预后相关。结论老年MACO患者预后较差。吸烟史及低血清白蛋白为死亡或脑卒中再发的独立危险因素，而高血压病史为保护性因素。

Objective To study the risk factors related to long - term prognosis in elderly patients with middle cerebral artery occlusion （MACO）. Methods All patients（ age ≥65 years） confirmed the presence of MCAO by the head and neck CT angiography （CTA） or magnetic resonance angiography （MRA） were collected retrospectively in Beijing Friendship Hospital from January 2006 to December 2013. Clinical data and related laboratory findings were collected. Those patients were followed up for the long - term prognosis. Death or recurrent stroke were considered as the end events. The influential factors were analyzed using univariate and multivariate logistic regression analysis. Results A total of 59 eases meeting the inclusion criteria were collected, 9 eases （15.25%） of which were lost. The patients were followed up for 53.02 （6 - 97） months. The incidence of end events was 48% , 19 eases （38%） died, 5 eases （ 10% ） occurred the stroke recurrence. Univariate and Logistic regression analysis showed that smoke history, hypertension and serum albumin were significantly related with the prognosis of patients. Coneluslon The prognosis of elderly patients with MCAO was poor. Smoke history and low serum albumin is an independent risk factor for recurrent stroke or death, and hypertension is a protective factor.