分水岭脑梗死进展的危险因素分析

Analysis of risk factors in progression of cerebral watershed infarction

目的探讨分水岭脑梗死(CWI)进展的危险因素。方法将191例CWI患者分为进展组和未进展组,比较两组的危险因素,并进行多因素Logistic回归分析。结果与未进展组比较,进展组吸烟史、高血压病史、发热、不稳定斑块、血管重度狭窄比率及低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)水平显著升高(均P<0.05)。多因素Logistic回归分析显示,发热(OR=2.497,95%CI:1.097~5.687,P=0.029)、不稳定斑块(OR=3.612,95%CI:1.608~8.116,P=0.002)、血管重度狭窄(OR=3.485,95%CI:1.624~7.477,P=0.001)、LDL(OR=1.381,95%CI:1.030~1.850,P=0.031)和Hcy(OR=1.080,95%CI:1.015~1.149,P=0.015)是CWI进展的独立危险因素。结论发热、不稳定斑块、血管重度狭窄和LDL、Hcy水平升高是CWI进展的独立危险因素。及时识别以上因素可以早期预测病情发展,加强对其控制可能会减少进展性脑梗死的发生。

Objective To investigate risk factors in progression of cerebral watershed infarction （CWI）. Methods One hundred and ninety-one CWI patients were divided into progress group and non-progress group. The risk factors of the two groups were compared, and muhifactor Logistic regression analysis was carried out. Results Compared with the non-progress group, the rates of smoking, hypertension, fever, unstable plaque, severe vascular stenosis and the levels of low density lipoprotein （LDL） and homocysteine （Hcy） in the progress group were significantly increased （ all P 〈 0. 05 ）. Multifactor Logistic regression analysis showed that fever （ OR = 2. 497, 95% CI：1. 097 - 5. 687, P = 0. 029）, unstable plaque （ OR = 3. 612, 95% CI： 1. 608 - 8. 116, P = 0. 002）, severe vascular stenosis （ OR = 3. 485, 95% CI： 1. 624 - 7. 477, P = 0. 001 ） , LDL level （ OR = 1. 381, 95% CI： 1. 030 - 1. 850, P =0. 031 ） and Hcy level （ OR = 1. 080, 95% CI： 1. 015 - 1. 149, P = 0. 015 ） were the independent risk factors for progression of CWI. Conclusions Fever, unstable plaque, severe vascular stenosis, high levels of LDL and Hcy are the independent risk factors for the progression of cerebral watershed infarction. Timely identification of these factors can predict the progression of the disease early, enhancing the control of these factors may reduce the occurrence of progressive cerebral infarction.