表现为脑梗死的孤立性前庭综合征危险因素分析

Analysis of risk factors in patients with cerebral infarction manifested as isolated vestibular syndrome

目的探讨表现为脑梗死的孤立性前庭综合征(IVS)患者的危险因素。方法回顾性收集2014年3月-2017年10月以IVS为症状就诊于神经内科治疗的患者,根据MRI-DWI及临床特征分为梗死组及非梗死组,采用Logistic回归分析两组间危险因素。同时,分析危险因素的个数与脑梗死发生风险的关系。结果共纳入197例患者,其中梗死组48例,非梗死组149例。Logstic回归结果提示脑卒中史、吸烟为IVS发生脑梗死的独立危险因素。其OR值分别为7.123和3.439(P<0.001)。具有3个及以上危险因素的患者发生脑梗死的风险是无危险因素者的8.137倍(95%CI 2.271~29.159,P=0.001)。结论脑卒中史、吸烟为表现为脑梗死的IVS患者的危险因素;大于3个及以上危险因素的IVS患者需警惕脑卒中的可能性。

Objective This study was aimed to determine risk factors for cerebral infarction in patients with the isolated vestibular syndromes(IVS)and to improve the diagnoses of IVS.Methods Patients with IVS who were admitted to the department of neurology between March 2014 and October 2017 were enrolled into the study.All patients underwent thorough physical examination and detailed medical histories were recorded.Patients were divided into cerebral infarction and non-cerebral infarction groups according to their clinical characteristics and MRI-DWI examination findings.Logistic regression was performed for comparing risk factors between the 2 groups after adjusting for possible confounding factors.Results One hundred and ninety-seven patients were enrolled into the study,including 48 cases of cerebral infarction group and 149 cases of the control gro up.We found that the history of stroke and smoke were the independent risk factors in patients with cerebral infarction manifested as IVS.The OR value was 7.123 and 3.439 respectively(P<0.001).IVS patients with≥3 risk factors had a 8.137-fold higher risk for stroke(95%CI 2.271~29.159,P=0.001)than those without risk factors.Conclusions The patients with IVS should have a comprehensive neurological examination,vascular risk factors survey,and regular follow-up for several years.Patients with 3 or more risk factors should be alert to the likelihood of stroke.