影响缺血性中风患者住院期间症状严重程度的因素及生化代谢分析

Factors associated with the severity of symptoms of ischemic stroke during hospitalization and biochemical-related analysis

目的探讨缺血性中风患者住院期间症状严重程度的影响因素,为其防治提供参考。方法采用美国国立卫生研究院卒中量表(NHISS)对133例缺血性中风患者入院及出院时症状的严重程度进行评估;同时,检查患者颈内动脉斑块及狭窄情况,并收集其并发症及常规血生化指标的水平,采用Spearman相关、逻辑回归等方法分析这些指标与NHISS评分的相关性,评估影响患者中风症状严重程度的因素。结果133例患者入院时及出院时NHISS评分分别为(6.3±4.6)、(5.4±4.7)(P=0.109),17例患者的NHISS评分在出院时较入院时增加。白细胞是症状加重的独立危险因素(OR=1.12),合并房颤及重度颈动脉狭窄的患者其NHISS评分更高。年龄、房颤病史、血糖水平、AST、WBC、CRP水平与NHISS评分正相关,TSH水平与NHISS评分负相关。结论中风患者住院期间与症状加重有关的因素包括,炎症、颈动脉狭窄、老年、房颤史,生化代谢紊乱可能参与这些因素加重中风症状的进程。

Objective We aimed to investigate factors associated with the severity of ischemic stroke(IS)symptoms during hospitalization,to offer an information for the prevention and therapy of IS.Methods We calculated NIHSS score,at admission and discharge,for each IS patient presenting to evaluate the severity of IS symptoms.The stenosis of their carotid arteries was investigated with color-coded duplex sonography and the biochemical data and combination information of these patients were collected.Then,we analyzed the correlations between the NHISS score and the clinical information including biochemical indices,stenosis of carotid arteries and combinations by spearman correlation and logistic regression.In addition,the differences of NHISS scores and biochemical parameters between patients with complications and those without,or with different levels of carotid stenosis were compared.Results A total of133IS patients were enrolled.Their NHISS scores at admission and at discharge were(6.3±4.6)and(5.4±4.7)(P=0.109),respectively.Seventeen patients had their NHISS scores increased during hospitalization.WBC count was an independent risk factor for worsening of IS symptoms during hospitalization(OR=1.12).Patients with atrial fibrillation or severe carotid stenosis had higher NHISS scores than those without.Age,the history of AF,and the levels of glucose,AST,WBC,CRP and HSCRP showed positive correlations,whereas the level of TSH showed a negative correlation with NHISS score.Conclusion The factors that exacerbate IS symptoms during hospitalization include inflammation,carotid stenosis,older age,the history ofAF,and blood biochemical disturbances may be involved in relative processes.