血清高半胱氨酸和硫化氢与老年后循环缺血性卒中患者转归的相关性研究

Analysis of the correlation between poor prognosis of patients with posterior circulation cerebral infarction and mixed sulfide,homocysteine and respiratory infection

目的探讨后循环脑梗死患者预后不良与硫化氢、同型半胱氨酸(Hcy)以及呼吸系统感染的相关性。方法回顾性分析本院2013年2月至2018年2月收治的60例后循环脑梗死患者的临床资料,根据患者的预后情况,39例为预后良好组,21例为预后不良组。通过单因素法比较两组患者的临床资料,再对具有统计学意义的单因素指标进行多因素Logistic回归分析,并通过Pearson法对后循环脑梗死患者预后不良与硫化氢、呼吸系统感染、同型半胱氨酸的相关性进行分析。结果两组患者在入院时NIHSS评分、血清Hcy、呼吸系统感染以及病变部位等一般资料差异具有统计学意义(t/P=8.731/<0.001,8.851/<0.001,10.924/0.001,11.307/0.023)。多因素Logistic回归分析显示,入院时NIHSS、血清Hcy、呼吸系统感染以及多区域病变是致后循环脑梗死预后不良的危险因素(P=0.028,0.040,0.016,0.003)。后循环脑梗死患者预后不良与硫化氢无相关性(r/p=0.132/0.368),与血清Hcy水平呈负相关,与呼吸系统感染呈正相关(r/P=-3.254/<0.001,0.374/0.023)。结论入院时NIHSS、血清Hcy、呼吸系统感染以及多区域病变是后循环脑梗死患者预后不良的危险因素,可为其早期治疗以及预后诊断提供参考。

Objective To explore the correlation between poor prognosis and mixed sulfide,homocysteine(Hcy)and respiratory infection in patients with posterior circulation cerebral infarction,so as to provide reference for clinical diagnosis and treatment.Methods The clinical data of 60 patients with posterior circulation cerebral infarction treated in our hospital from February 2013 to February 2018 were retrospectively analyzed.According to the prognosis of patients,39 cases were in the good prognosis group and 21 cases were in the poor prognosis group.The clinical data of the two groups were compared by single factor method,and then the statistically significant single factor indexes were analyzed by multivariate logistic regression analysis.The correlation between poor prognosis and mixed sulfide,respiratory infection and homocysteine in patients with posterior circulation cerebral infarction was analyzed by Pearson method.Results There were significant differences in NIHSS score,serum Hcy,respiratory infection and lesion location between the two groups(t/P=8.731/<0.001,8.851/<0.001,10.924/0.001,11.307/0.023).Multivariate logistic regression analysis showed that NIHSS,serum Hcy,respiratory infection and multi regional lesions were the risk factors for poor prognosis of posterior circulation cerebral infarction(P=0.028,0.040,0.016,0.003).There was no correlation between poor prognosis and hydrogen sulfide in patients with posterior circulation cerebral infarction(r/P=0.132/0.368).It was negatively correlated with serum Hcy level and positively correlated with respiratory infection(r/P=-3.254/<0.001,0.374/0.023).Conclusion NIHSS,serum Hcy,respiratory infection and multi regional lesions are risk factors for poor prognosis of patients with posterior circulation cerebral infarction,which can provide reference for early treatment and prognostic diagnosis.