脉络膜前动脉梗死患者预后影响因素分析

Analysis of prognostic factors in patients with anterior choroid artery infarction

目的探讨影响脉络膜前动脉(ACh A)梗死患者预后的相关因素。方法回顾性分析2017年9月至2019年10月濮阳市安阳地医院收治的37例孤立性ACh A梗死患者的临床资料,分析影响ACh A梗死患者预后的相关因素。结果37例ACh A梗死患者中发生进展18例,进展性ACh A梗死的发生率为51.4%。进展性ACh A梗死与糖尿病史、入院时改良Rankin量表(mRS)评分、最重时美国国立卫生研究院率中量表评分、3月后mRS评分、溶栓治疗有关(P<0.05),与性别、高血压、高脂血症、冠状动脉粥样硬化性心脏病、心房颤动病史、吸烟史、血管狭窄>70%、梗死位置、临床症状无关(P>0.05)。多因素logistic回归分析显示,入院时mRs评分、静脉溶栓治疗是影响ACh A梗死患者预后的危险因素(P<0.05)结论ACh A梗死病情进展率较高,糖尿病患者更易出现临床进展,静脉溶栓治疗可能为有效的治疗方法。

Objective To investigate the prognostic factors of patients with anterior choroidal artery(ACh A)infarction.Methods The clinical data of 37 patients with isolated ACh A infarction admitted to Anyang District Hospital of Puyang City from September 2017 to October 2019 were analyzed retrospectively,and the relevant factors affecting the prognosis of patients with ACh A infarction were analyzed.Results Eighteen of the 37 patients with ACh A infarction developed,and the incidence of progressive ACh A infarction was 51.4%.Progressive ACh A infarction was associated with history of diabetes,modified rankin scale(mRS)score at admission,National Institute of Health stroke scale score at the peak,mRS score after 3 months,and thrombolytic therapy(P<0.05),but it was not associated with gender,hypertension,hyperlipidemia,coronary heart disease,history of atrial fibrillation,smoking history,vascular stenosis>70%,location of infarction,or clinical symptoms(P>0.05).Multivariate logistic regression analysis showed that mRs score and intravenous thrombolytic therapy were the risk factors influencing the prognosis of patients with ACh A infarction(P<0.05).Conclusion ACh A infarction has a higher rate of progression,and the patients combined with diabetic are more prone to clinical progression,and intravenous thrombolysis may be an effective treatment for it.