进展性缺血性脑卒中发生率及危险因素分析

Analysis of Incidence and Risk Factors of Progressive Ischemic Stroke

目的:分析进展性缺血性脑卒中(PIS)发生率及危险因素。方法:回顾性分析2019年8月-2021年8月福鼎市医院神经内科收治的83例缺血性脑卒中患者的病历资料,根据病情是否进展分为PIS组和非PIS组,比较两组的性别、年龄、病程、脑卒中程度[美国国立卫生研究院卒中量表(NIHSS)]、糖尿病史、高血压史、高脂血症史、冠心病史、抽烟史、酗酒史、空腹血糖、甘油三酯、高密度脂蛋白、低密度脂蛋白、血尿酸、高敏C反应蛋白、D-二聚体、舒张压、收缩压、颈动脉斑块等指标,以差异有统计学意义的影响因素做自变量进行多因素Logistic回归分析。结果:83例脑卒中患者中有22例发展为PIS,发生率为26.51%(22/83);两组的糖尿病史、空腹血糖、高血压、收缩压、舒张压、D-二聚体、颈动脉斑块比较,差异有统计学意义(P<0.05);上述影响因素经Logistic回归分析表明,入院的空腹血糖较高、D-二聚体水平高、存在不稳定颈动脉斑块为缺血性脑卒中患者发展为PIS的独立危险因素(P<0.05)。结论:缺血性脑卒中患者转变为PIS的危险因素较多,在入院评估过程中筛查除危险因素的患者,在后续临床治疗中应予以重点关注,以避免发展为PIS,增加病死风险。

Objective:To analyze the incidence and risk factors of progressive ischemic stroke (PIS).Method:Retrospective analysis was made on the medical records of 83 patients with ischemic stroke admitted to the Department of Neurology of Fuding Hospital from August 2019 to August 2021.They were divided into PIS group and non PIS group according to the progress of the disease.The gender,age,course of disease,degree of stroke[National Institute of Health stroke scale (NIHSS)],history of diabetes,history of hypertension,history of hyperlipidemia,history of coronary heart disease,history of smoking,history of alcoholism,fasting blood glucose,triglycerides,high-density lipoprotein,low-density lipoprotein,blood uric acid,hypersensitive C-reactive protein,D-dimer,diastolic blood pressure,systolic blood pressure and carotid plaque were compared between the two groups.Multivariate logistic regression analysis was conducted with statistically significant influencing factors as independent variables.Result:Among 83 stroke patients,22 patients developed into PIS,with an incidence of 26.51% (22/83).The baseline data of the two groups showed that there were significant differences in diabetes history,fasting blood glucose,hypertension,systolic blood pressure,diastolic blood pressure,D-dimer and carotid plaque between the two groups (P<0.05).Logistic regression analysis showed that high fasting blood glucose,high D-dimer level and unstable carotid plaque were independent risk factors for the development of PIS in patients with ischemic stroke (P<0.05).Conclusion:There are many risk factors for ischemic stroke patients to change to PIS.Patients with risk factors should be screened in the process of admission evaluation,and special attention should be paid in the follow-up clinical treatment,so as to avoid developing into PIS and increase the risk of death.