青海地区急性脑梗死患者2年预后不良的临床特点分析

Clinical characteristics of 2-year poor prognosis in patients with acute cerebral infarction in Qinghai

目的探讨青海地区急性脑梗死患者2年预后不良的临床特点。方法选择青海地区2015年6月至2017年6月急性脑梗死住院患者143例,随访2年根据预后情况分为预后良好组109例与预后不良组34例。调查因素包括性别、年龄、文化程度、体质量指数(BMI)、吸烟史、饮酒史、合并高血压、合并糖尿病、合并冠心病、入院时美国国立研究院卒中量表(NIHSS)评分、心房颤动、梗死部位、梗死体积、格拉斯哥昏迷量表(GCS)评分及入院1h内溶栓治疗。采用单因素分析影响急性脑梗死预后不良相关因素;采用多因素Logistic回归分析影响急性脑梗死预后不良危险因素。结果急性脑梗死患者143例中随访2年,预后不良患者34例,发生率为23.78%。经单因素分析结果显示,两组性别、文化程度、BMI、吸烟史、饮酒史、合并高血压、合并糖尿病、合并冠心病、梗死部位及入院1 h内溶栓治疗比较差异无统计学意义(P> 0.05);两组年龄、入院时NIHSS评分、心房颤动、梗死体积和GCS评分比较差异具有统计学意义(χ^2=11.124、8.895、10.839、13.537、11.664,P <0.05)。多因素Logistic回归分析显示,年龄、入院时NIHSS评分、心房颤动、梗死体积和GCS评分为影响急性脑梗死预后不良危险因素(OR=1.684、3.013、2.547、2.091、3.897,P <0.05)。结论青海地区急性脑梗死患者2年预后不良受多因素影响,其中年龄、入院时NIHSS评分、心房颤动、梗死体积和GCS评分为其危险因素,为改善患者预后,需采取针对性预防措施。

Objective To investigate the clinical characteristics of 2-year poor prognosis in patients with acute cerebral infarction in Qinghai.Methods 143 patients with acute cerebral infarction in Qinghai from June 2015 to June 2017 were selected,and divided into good prognosis group(n=109)and poor prognosis group(n=34)according to the prognosis followed up for 2 years.The factors included gender,age,education level,body mass index(BMI),smoking history,drinking history,hypertension,diabetes mellitus,coronary heart disease,NIHSS score at admission,atrial fibrillation,infarct location,infarct volume,Glasgow coma scale(GCS)score and thrombolysis within one hour after admission.Univariate analysis was used to analyze the related factors affecting the poor prognosis of acute cerebral infarction,and multivariate logistic regression was used to analyze the risk factors affecting the poor prognosis of acute cerebral infarction.Results 143 patients with acute cerebral infarction were followed up for 2 years,34 patients had poor prognosis,the incidence was 23.78%.Univariate analysis showed that there were no significant difference in gender,education level,BMI,smoking history,drinking history,hypertension,diabetes mellitus,coronary heart disease,infarct location and thrombolysis within one hour after admission between the two groups(P>0.05).There were significant differences in age,NIHSS score at admission,atrial fibrillation,infarct volume and GCS score between the two groups(χ~2=11.124,8.895,10.839,13.537,11.664,P<0.05).The results of logistic regression analysis showed that age,NIHSS score at admission,atrial fibrillation,infarct volume and GCS score were the risk factors of poor prognosis of acute cerebral infarction(OR=1.684,3.013,2.547,2.091,3.897,P<0.05).Conclusion The 2-year poor prognosis of patients with acute cerebral infarction in Qinghai is affected by many factors,age,NIHSS score at admission,atrial fibrillation,infarct volume and GCS score are the risk factors.In order to improve the prognosis of patients,targeted preventive measures should be taken.