进展性缺血性卒中预后的相关因素分析

Analysis about Related Factors of Prognosis in Progressive Ischemic Stroke Patients

目的:探究进展性缺血性卒中预后的相关危险因素。方法:选取进展性缺血性卒中患者98例,根据复发情况将患者分为复发组和无复发组,分析进展性缺血性卒中复发与二级预防的关系。无复发组的患者按根据随访的mRS评分高低分为:预后良好组(mRS 0~2分)和预后差组(mRS 3~5分),分析影响预后的相关因素。结果:98例进展性缺血性卒中患者六个月复发率为10.2%(10/98)。无复发组较复发组应用降压药、降糖药、抗血小板聚集药物、他汀类降脂药的患者比例较复发组高,两组比较差异均具有统计学意义(P<0.05)。无复发组患者出院后一个月、三个月及六个月,单因素分析入院时白细胞计数、LDL、血糖与预后相关(P<0.05)。多因素logistic回归分析LDL、血糖和白细胞计数是影响出院后一个月预后的危险因素;血糖和白细胞计数是影响出院后三个月预后的危险因素;LDL和血糖是影响出院后六个月预后的危险因素。结论:良好的二级预防依从性有利于降低进展性缺血性卒中的复发率。入院时白细胞计数、LDL、血糖是影响进展性缺血性卒中预后的相关因素。入院时白细胞计数、LDL及空腹血糖值较高的进展性缺血卒中患者,其预后往往较差。

Objective： To analyze the possible risk factors of progressive ischemic stroke prognosis. Methods： 98 progressive ischemic stroke patients were selected and according to the recurrence, the patients were divided into the recurrent group and the non recurrent group. Then the relationship between recurrence and secondary prevention was analyzed. The patients in the non recurrent group were divided into the good prognosis group with mRS score from 0 to 2 and bad prognosis group with mRS score from 3 to 5. Then the relationship between prognosis and risk factors at 1^st, 3^rd and 6th month post discharge were analyzed. Results： The recurrent rate of the progressive ischemic stroke patients was 10.2%（10/98） in six months. Compared with the recurrent group, the patients in the non recurrent group continued to use secondary prevention medications such as anti-hypertensive drugs, antidiabetes drugs, antiplatelet drug and lipid lowing drugs post discharge, and the difference was statistically significant （P〈0.05）. In non recurrent group at 1^st, 3^rd and 6^th month discharged, the levels of white blood cell count, LDL and glucose were correlated with prognosis （P〈0.05）. According to the multivariable logistic regression analysis, the levels of white blood cell count, LDL and glucose were the risk factors of poor prognosis at 1^st month post discharge, the levels of white blood cell count and glucose were the risk factors of poor prognosis at 3^rd month post discharge, and the levels of LDL and glucose were the risk factors of poor prognosis at 6^th month after discharge. Conclusions： Secondary prevention is good for reducing the recurrence rate of progressive ischemic stroke. The levels of white blood cell count, LDL and glucose are the risk factors of progressive ischemic stroke prognosis. The higher levels of white blood cell and LDL and glucose might be the main risk factors of poor prognosis.