青年脑梗死患者神经功能短期改善的相关因素分析

Analysis of related factors of short-term improvement of neurological function in young patients with cerebral infarction

目的研究青年脑梗死患者神经功能短期改善与发病因素的相关性。方法回顾性分析2017年9月至2020年5月在南京市江宁医院住院的青年脑梗死患者,年龄<45周岁,共82例,收集患者年龄、性别、入院时血糖、同型半胱氨酸(Hcy)、尿酸、糖化血红蛋白、舒张压、收缩压、入院时和入院72 h内美国国立卫生研究院卒中量表评分(NIHSS)、入院72 h内的舒张压变异率、收缩压变异率、应激性高血糖比率等指标,分析青年脑梗死患者神经功能短期改善率与发病因素的相关性。结果两种疾病均无组患者年龄小于高血压病组及两种疾病均有组,差异有统计学意义(P<0.05)。四组患者NIHSS评分改善率比较,差异无统计学意义(P>0.05)。NIHSS评分改善率与入院时舒张压、收缩压、Hcy、应激性高血糖比率及住院期间的舒张压变异率、收缩压变异率呈负相关,相关系数分别为(r=-0.319,P=0.003)、(r=-0.282,P=0.010)、(r=-0.808,P=0.000)、(r=-0.502,P=0.000)、(r=-0.803,P=0.000)及(r=-0.593,P=0.000),与患者的年龄、性别、随机血糖、糖化血红蛋白及尿酸无显著相关性(P>0.05)。结论高血压病和糖尿病不是青年脑梗死患者神经功能短期改变独立因素,青年脑梗死患者神经功能短期的改善和患者入院时的舒张压、收缩压、Hcy、应激性高血糖比率及住院期间的舒张压变异率、收缩压变异率相关性显著,对血压和血糖的平稳控制有利于青年脑梗死患者神经功能的恢复。

Objective To study the correlation between the short-term improvement of neurological function and the pathogenic factors in young patients with cerebral infarction(CI).Methods A total of 82 young patients with CI,younger than 45 years old,who were hospitalized in the Affiliated Jiangning Hospital of Nanjing Medical University from September 2017 to May 2020,were retrospectively analyzed.The age,gender,blood glucose at admission,homocysteine(Hcy),uric acid,glycosylated hemoglobin,diastolic blood pressure(DBP),systolic blood pressure(SBP),National Institutes of Health Stroke Scale(NIHSS)score at admission and within 72 hours after admission,variation rate of DBP within 72 hours after admission,variation rate of SBP and stress hyperglycemia rate(SHR)were collected.The correlation between the short-term improvement rate of neurological function and the pathogenic factors in young patients with CI were analyzed.Results The patients in neither group were younger than those in hypertension group and hypertension+CI group,with statistically significant difference(P<0.05).There was no significant difference in NIHSS score among the four groups(P>0.05).The improvement rate of NIHSS score was negatively correlated with the rate of DBP(r=-0.319,P=0.003),SBP(r=-0.282,P=0.010),Hcy(r=-0.808,P=0.000)and SHR(r=-0.502,P=0.000)at admission,and the variation rate of DBP(r=-0.803,P=0.000)and SBP(r=-0.593,P=0.000)during hospitalization.The improvement rate had no significant correlation with age,gender,random blood glucose,glycosylated hemoglobin and uric acid(P>0.05).Conclusion Hypertension and diabetes are not independent factors of short-term changes of neurological function in young patients with CI.The short-term improvement of neurological function in young patients with CI is significantly related to the DBP,SBP,Hcy and SHR at admission,and the variability of DBP and SBP during hospitalization.Stable control of blood pressure and blood sugar is beneficial to the recovery of neurological function in young patients with CI.