急性大血管闭塞性脑梗死的危险因素分析

Analysis of risk factors for acute cerebral infarction of large vessel occlusion

目的探讨急性大血管闭塞性(LVO)脑梗死的危险因素。方法根据影像学检查将206例急性脑梗死患者分为前循环脑梗死组及后循环脑梗死组,进一步分为LVO亚组及非LVO亚组。收集患者的临床资料并进行分析。结果与前循环脑梗死组非LVO亚组比较,LVO亚组女性、心房纤颤、意识障碍、凝视、面瘫、上肢瘫痪、下肢瘫痪、感觉障碍、失语比率及NIHSS评分显著升高(均P<0.05),共济失调比率显著降低(P<0.05)。与后循环脑梗死组非LVO亚组比较,LVO亚组心房纤颤、意识障碍比率及NIHSS评分显著升高(均P<0.05)。多因素Logistic回归分析显示,女性、心房纤颤是前循环大血管闭塞的独立危险因素(OR=0.498,95%CI:0.254-0.979;OR=2.484,95%CI:1.259-4.899),凝视、失语对预测前循环大血管闭塞有统计学意义(OR=4.487,95%CI:1.791-11.243;OR=5.113,95%CI:1.773-14.744)。结论女性、心房纤颤是前循环大血管闭塞的独立危险因素,凝视、失语对预测前循环大血管闭塞有统计学意义。

Objective To investigate the risk factors for acute cerebral infarction of large vessel occlusion(LVO).Methods According to the imaging examination, 206 patients with acute cerebral infarction were divided into anterior circulation infarction group and posterior circulation infarction group, and further divided into LVO subgroup and non-LVO subgroup. Clinical data of patients were collected and analyzed. Results Compared with those in non-LVO subgroup of anterior circulation infarction group, the rates of female, atrial fibrillation, the disorder of consciousness, gaze, facial paralysis, upper limb paralysis, lower limb paralysis, hypesthesia, aphasia and higher NIHSS score in LVO subgroup were significantly higher(all P<0.05), and ataxia rate was significantly lower(P<0.05). Compared with those in non-LVO subgroup of posterior circulation infarction group, the rates of atrial fibrillation, disorder of consciousness and NIHSS score in LVO subgroup were significantly higher(all P<0.05). Multivariate Logistic regression analysis showed that female and atrial fibrillation were independent risk factors for anterior circulation LVO(OR=0.498, 95%CI: 0.254-0.979;OR=2.484, 95%CI: 1.259-4.899), gaze and aphasia were statistically significant in the prediction of anterior circulation LVO(OR=4.487, 95%CI: 1.791-11.243;OR=5.113, 95%CI: 1.773-14.744).Conclusion Female and atrial fibrillation are independent risk factors for anterior circulation LVO, and gaze and aphasia are statistically significant in predicting anterior circulation LVO.