进展性穿支动脉病变型脑梗死危险因素分析

Risk factors for progressive cerebral infarction due to lesion of penetrating artery

目的 分析中国缺血性脑卒中亚分类(CISS)分型中穿支动脉病变型脑梗死进展的危险因素,为穿支动脉病变型脑梗死进展预测提供帮助。方法 回顾性连续收集穿支动脉病变型脑梗死患者病例资料,根据美国国立卫生研究院卒中量表(NIHSS)评分评估患者病情是否进展,应用统计学分析可能影响穿支动脉病变型脑梗死进展的危险因素。结果 共纳入310例研究对象,其中进展组92例(29.7%),非进展组218例(70.3%)。单因素分析显示,入院时收缩压、入院时舒张压、入院时NIHSS评分、颅内血管轻度狭窄例数差异有统计学意义(P<0.05)。多因素二元Logistic回归分析显示入院时舒张压(OR=1.027,95%CI 1.000~1.054,P=0.046)、入院时NIHSS评分(OR=1.171,95%CI 1.030~1.331,P=0.016)及颅内血管轻度狭窄例数(OR=2.827,95%CI 1.637~4.881,P=0.000)为进展性穿支动脉病变型脑梗死的独立危险因素。结论 入院时舒张压、入院时NIHSS评分、颅内血管轻度狭窄例数为进展性穿支动脉病变型脑梗死的独立危险因素。

Objective To analyze the risk factors for cerebral infarction progression with penetrating ar-tery lesions in CISS classification,in order to provide help to predict the progression of penetrating artery lesion cerebral infarction.Methods Retrospective data of patients with penetrating artery lesions with cerebral infarc-tion were collected.The NIHSS score was used to assess whether the patient had progressed.The risk factors that may affect the progression of penetrating artery lesion cerebral infarction were analyzed statistically.Results A total of 310 subjects were included,including 92 cases(29.7%)in the progressive group and 218 cases(70.3%)in the non-progressive group.Univariate analysis showed that there were statistically significant differences in sys-tolic blood pressure,diastolic blood pressure,NIHSS score and the number of cases of intracranial mild vascular stenosis at admission(P<0.05).Multivariate binary Logistic regression analysis showed that diastolic blood pres-sure at admission(OR=1.027,95%CI 1.000-1.054,P=0.046),NIHSS score at admission(OR=1.171,95%CI 1.030-1.331,P=0.016)and the number of cases of intracranial mild vascular stenosis(OR=2.827,95%CI 1.637-4.881,P=0.000)were independent risk factors for progressive penetrating artery lesion cerebral infarction.Conclusion Diastolic blood pressure at admission,NIHSS score at admission and the number of intracranial mild vascular stenosis cases are independent risk factors for progressive penetrating artery disease cerebral infarction.