急性缺血性脑卒中合并脑心综合征的临床特点和相关危险因素分析

Clinical characteristics and related risk factors of acute ischemic stroke complicated with cerebral cardiac syndrome

目的探讨急性缺血性脑卒中(acute ischemic stroke,AIS)并发脑心综合征(cerebral cardiac syndrome,CCS)的临床特点,并分析引起CCS的高危因素。方法采用病例对照研究方法,收集2019年1月至2021年5月本院收住监护病房的AIS患者的临床资料进行统计分析。根据卒中后是否发生CCS,将患者分为CCS组和对照组。分析AIS合并CCS的临床表现特点,并分析CCS发生的相关危险因素。结果共纳入196例AIS患者,92例合并CCS,74例在AIS后72 h内发生。经二元Logistic回归分析,高龄(OR=1.15,95%CI:1.01~1.23)、高血压病(OR=1.41,95%CI:1.26~1.58)、糖尿病(OR=2.05,95%CI:1.86~2.24)、慢性肾病(OR=1.36,1.22~1.48)、慢性阻塞性肺病(OR=1.46,95%CI:1.22~2.48)、吸烟史(OR=1.52,95%CI:1.23~1.78)、高NISSH评分(OR=1.36,95%CI:1.29~1.48)、脑干梗死(OR=2.33,95%CI:2.21~2.50)、丘脑梗死(OR=1.21,95%CI:1.17~1.28),高脂血症(OR=1.86,95%CI:1.61~1.96)等与卒中后CCS的发生相关。结论CCS是AIS患者常见并发症,且多在卒中后72 h内发生。高血压病、糖尿病、慢性肾脏病、吸烟史、神经功能损伤程度、脑干梗死、丘脑梗死和高脂血症是CCS发生的危险因素。对有相关危险因素的AIS患者应严密心脏监测,谨防心脏事件发生。

Objective To investigate the clinical characteristics and risk factors of acute ischemic stroke(AIS)complicated with cerebral cardiac syndrome(CCS).Methods The clinical data of AIS patients admitted to the ICU of our hospital from January 2019 to May 2021 were collected and retrospectively analyzed.According to whether CCS occured after stroke,the patients were divided into the CCS group and control group.Binary logistic regression analysis was used to analyze the clinical characteristics of AIS combined with CCS and the risk factors for the occurrence of CCS.Results A total of 196 patients with AIS were included,and 92 patients had CCS,of which 74 occurred within 72 h after AIS.Binary logistic regression analysis showed that old age(OR=1.15,95%CI:1.01-1.23),hypertension(OR=1.41,95%CI:1.26-1.58),diabetes(OR=2.05,95%CI:1.86-2.24),chronic kidney disease(OR=1.36,95%CI:1.22-1.48),chronic obstructive pulmonary disease(OR=1.46,95%CI:1.22-2.48),smoking(OR=1.52,95%CI:1.23-1.78),higher NISSH score(OR=1.36,95%CI:1.29-1.48),brainstem infarction(OR=2.33,95%CI:2.21-2.50),thalamic infarction(OR=1.21,95%CI:1.17-1.28),and hyperlipidemia(OR=1.86,95%CI:1.61-1.96)were associated with the occurrence of CCS after stroke.Conclusions CCS is a common complication in patients with AIS,and mostly occurs within 72 hours after stroke.The risk of CCS is not only related to the history of hypertension,diabetes,chronic kidney disease,smoking history and hyperlipidemia,but also related to the location of infarction and the degree of nerve function injury.The changes of cardiac function in patients with AIS should be closely monitored to prevent cardiac events.