腔隙性脑梗死早期神经功能恶化的危险因素分析

Analysis of related risk factors of early neurological deterioration in patients with lacunar infarction

目的 探讨急性腔隙性脑梗死（LI）患者发生早期神经功能恶化（END）的相关危险因素。方法 连续选择2015年6月~2016年6月收治于我院神经内科的急性LI患者,依据LI发病后72 h内是否出现END,将患者分为END组和非END组。比较两组患者的一般临床资料、血液生化指标及影像学指标,进行单因素及多因素相关分析,筛选出影响END的相关危险因素。结果 单因素分析结果显示,END组患者的年龄、糖尿病史、基线收缩压、基线美国国立卫生研究院卒中量表（NIHSS）评分、血清同型半胱氨酸、后循环病灶、责任动脉狭窄率≥50%与非END组比较差异有统计学意义（P〈0.05）。多因素Logistic回归分析结果显示年龄、基线NIHSS评分、责任动脉狭窄率≥50%是发生END的独立预测因素。结论 高龄、基线NIHSS评分高以及责任动脉狭窄率≥50%是急性LI患者发生END的独立危险因素,这些危险因素有助于评估LI的病情发展及判断预后。

Objective To explore the risk factors of early neurological deterioration（END） in patients with acute lacunar infarction. Methods Consecutive patients with acute lacunar infarction were admitted to our hospital from June 2015 to June 2016. Patients were divided into END group and non-END group according to whether there was early neurological deterioration within 72 h. The general clinical data, blood biochemical indexes and imaging indexes were compared between the two groups. Related risk factors were selected through univariate and multivariate analysis. Results Uni- variate analysis showed that age, history of diabetes, systolic blood pressure, baseline National Institute of Health Stroke Scale （NIHSS） scores, serum homoeysteine, posterior circulation lesions and responsible artery stenosis rate ≥50% were associated with END. There were statistically significant differences between END and non-END group（P〈0.05）. Logistic regression analysis showed that age, baseline NIHSS scores and responsible artery stenosis rate ≥ 50% were the independent factors for END. Conclusion Age, baseline NIHSS scores and responsible artery stenosis rate ≥ 50% are the independent predictors for END in patients with acute lacunar infarction. These, risk factors may help to evaluate the development and the prognosis of acute lacunar infarction.