急性缺血性脑血管病患者脑微出血发生的危险因素分析

Analysis on the risk factors of cerebral microbleed in patients with acute ischemic cerebrovascular disease

目的探讨急性缺血性脑血管病患者脑微出血发生的危险因素。方法纳入2014年10月~2016年10月本院收治的158例急性缺血性脑血管病患者,根据是否发生CMB进行分组,将发生CMB的38例患者作为试验组,未发生CMB的120例患者作为对照组。比较两组一般资料、入院检查结果、NIHSS评分、GCS评分,Logistic多因素分析急性缺血性脑血管病患者CMB发生的危险因素。结果两组冠心病、饮酒、吸烟、糖尿病、高血压患病情况比较,差异均无统计学意义(P>0.05);试验组心房颤动、高胆固醇血症占比均明显高于对照组(P<0.05)。试验组NIHSS评分、血小板计数、血浆凝血酶原时间、血糖均明显高于对照组,GCS评分明显低于对照组(P<0.05);两组纤维蛋白原比较,差异均无统计学意义(P>0.05)。心房颤动、高胆固醇血症是急性缺血性脑血管病患者CMB发生的危险因素(P<0.05)。结论心房颤动、高胆固醇血症的急性缺血性脑血管病患者,应高度警惕CMB发生,临床医师应根据患者具体情况进行针对性处理。

Objective To investigate the risk factors of cerebral microbleed(CMB)in patients with acute ischemic cerebrovascular disease.Methods From October 2014 to October 2016,158 patients with acute ischemic cerebrovascular disease admitted to our hospital were divided into the experimental group(n=38,with CMB)and the control group(n=120,without CMB)according to whether CMB occurred.The general data,admission examination results,NIHSS scores and GCS scores between the two groups were compared.Meanwhile,Logistic multivariate analysis was used to analyze the risk factors of CMB in patients with acute ischemic cerebrovascular disease.Results There were no statistically significant differences in the prevalence of coronary heart disease,drinking,smoking,diabetes and hypertension between the two groups(P>0.05).The ratios of atrial fibrillation and hypercholesterolemia in the experimental group were significantly higher than those in the control group(P<0.05).NIHSS scores,platelet counts,plasma prothrombin time and blood glucose in the experimental group were significantly higher than those in the control group,while GCS scores were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in fibrinogen between the two groups(P>0.05).Atrial fibrillation and hypercholesterolemia were the risk factors of CMB in patients with acute ischemic cerebrovascular d i s e a s e(P<0.05).Conclusion Patients with acute ischemic cerebrovascular disease complicated with atrial fibrillation and hypercholesterolemia should be highly alert to the occurrence of CMB,and clinicians should make targeted treatment according to the specific conditions of patients.