急性后循环脑梗死患者早期神经功能恶化的影响因素分析

Influencing factors of early neurological deterioration in acute posterior circulation cerebral infarction patients

目的分析急性后循环脑梗死(acute posterior circulation infarction,APCI)患者早期神经功能恶化(early neurological deterioration,END)的影响因素。方法连续收集2017年6月~2018年3月在辽宁省人民医院神经内科住院的APCI患者297例,将其分为END组33例及非END组264例,比较2组的临床资料及影像特点,用多因素logistic回归分析END的影响因素。结果 END组女性比例、基线美国国立卫生研究院卒中量表评分、中段脑梗死、椎动脉狭窄、基底动脉狭窄和大脑后动脉狭窄发生率明显高于非END组,差异有统计学意义[48.48%vs29.17%,5.00(3.00,8.00)分vs 3.00(1.00,4.00)分,87.88%vs 55.68%,48.48%vs 30.30%,39.39%vs 15.91%,36.36%vs 15.15%,P<0.05,P<0.01]。多因素回归分析显示,女性(OR=2.478,95%CI:1.124~5.461,P=0.024)和中段脑梗死(OR=4.444,95%CI:1.450~13.621,P=0.009)是发生END的独立影响因素。结论 APCI患者中,女性和中段脑梗死是发生END的独立危险因素。

Objective To analyze the influencing factors of early neurological deterioration(END)in acute posterior circulation infarction(APCI)patients.Methods Two hundred and ninety-seven APCI patients admitted to our hospital from June 2017 to March 2018 were divided into END group(n=33)and END-free group(n=264).Their clinical and imaging characteristics were compared.The influencing factors of END were analyzed by multivariate logistic regression analysis.Results The ratio of females,baseline NIHSS score and incidence of middle segment cerebral infarction,vertebral artery stenosis,basilar artery stenosis,posterior cerebral artery stenosis were significantly higher in END group than in END-free group[48.48%vs 29.17%,5.00(3.00,8.00)vs 3.00(1.00,4.00),87.88%vs 55.68%,48.48%vs 30.30%,39.39%vs 15.91%,36.36%vs 15.15%,P<0.05,P<0.01].Multivariate logistic regression analysis showed that gender and middle segment cerebral infarction were the independent factors for END in APCI patients(OR=2.478,95%CI:1.124-5.461,P=0.024;OR=4.444,95%CI:1.450-13.621,P=0.009).Conclusion Females and middle segment cerebral infarction are the independent risk factors for END in APCI patients.