大动脉粥样硬化型脑梗死病情进展的预测因素

Predictors of progressive ischemic stroke caused by large artery atherosclerosis

目的:探讨大动脉粥样硬化(Large Artery Atherosclerosis,LAA)型脑梗死病情进展的预测因素。方法:选取收治的急性LAA型脑梗死患者173例。采用斯堪地那维亚卒中量表(Scandinavian Stroke Scale,SSS)评估患者病情是否发生进展,收集患者的病史资料、实验室及影像学检查结果。对LAA型进展性卒中的发生率及预测因素进行分析。结果:LAA型进展性卒中的发生率为23.1%;入院时血压、H型高血压、高同型半胱氨酸血症(Hyperhomocysteinemia,HHcy)、颅内外动脉狭窄与LAA型脑梗死病情进展相关;入院时收缩压、H型高血压、HHcy、颅内动脉狭窄对LAA型脑梗死病情进展有显著预测作用。结论:H型高血压、颅内动脉狭窄、入院时收缩压及HHcy是LAA型脑梗死病情进展的独立预测因素。

Objective To investigate the predictors of progressive ischemic stroke caused by large artery atherosclerosis（ LAA）. Method 173 cases of hospitalized patients with acute ischemic stroke caused by LAA were selected. The patients were investigated by Scandinavian Stroke Scale to evaluate whether the ischemic stroke was progressive. Collecting the patient＇s medical history information,laboratory and imaging examination results,to analyz the incidence and the predictors of progressive ischemic stroke caused by LAA. Results The incidence of progressive ischemic stroke caused by LAA was 23. 1%. The related factors of progressive ischemic stroke caused by LAA included： Blood pressure on admission,H- type hypertension,Hyperhomocysteinemia,Intracranial and extracranial artery stenosis. Systolic blood pressure on admission,H- type hypertension,Hyperhomocysteinemia,Intracranial artery stenosis can significantly predict progressive ischemic stroke caused by LAA. Conclusion H- type hypertension,Intracranial artery stenosis,Systolic blood pressure on admission and Hyperhomocysteinemia are independent predictors of progressive ischemic stroke caused by LAA.