急性缺血性脑卒中发生的危险因素分析

Analysis of risk factors for the occurrence of acute ischemic stroke

目的探讨急性缺血性脑卒中发生的独立危险因素。方法将2020年1月至2021年12月于首都医科大学附属北京世纪坛医院住院治疗的168例急性缺血性脑卒中患者作为病例组,并按年龄、性别匹配,将168例同期健康体检者作为对照组。比较两组患者的基本临床特征、颈动脉粥样硬化斑块(ACP)超声检查结果,分析急性缺血性脑卒中发生的危险因素。结果病例组有高血压史、有糖尿病史、有高脂血症史、吸烟、饮酒、有冠心病史、ST-T改变、有脂肪肝的比例,以及体重指数、收缩压、舒张压、总胆固醇水平、甘油三酯水平、低密度脂蛋白胆固醇水平、空腹血糖、C反应蛋白水平均高于对照组,高密度脂蛋白胆固醇水平低于对照组(P﹤0.05)。颈动脉斑块超声检查结果显示,病例组的ACP数量和积分均明显高于对照组(P﹤0.01)。两组研究对象的斑块性质比较,差异有统计学意义(P﹤0.05),其中,病例组的不稳定斑块数量较多。多因素分析结果显示,ACP积分≥2分、有高血压史、有糖尿病史、C反应蛋白水平升高均是急性缺血性脑卒中发生的独立危险因素(P﹤0.05)。结论ACP积分≥2分、有高血压史、有糖尿病史、C反应蛋白水平升高均是急性缺血性脑卒中发生的独立危险因素,临床中应密切关注此类患者。

Objective To analyze the risk factors for the occurrence of acute ischemic stroke.Method From January 2020 to December 2021,168 patients with acute ischemic stroke who were hospitalized in the Beijing Shijitan Hospital,Capital Medical University were selected as the case group,168 healthy subjects matched by age and gender and enrolled in control group.The basic clinical characteristics and atherosclerotic carotid plaque(ACP)ultrasonography results of two groups were compared.The risk factors for the occurrence of acute ischemic stroke was analyzed.Result The proportion of patients with history of hypertension,history of diabetes,history of hyperlipidemia,smoking,drinking,history of coronary heart disease,ST-T changes,fatty liver,and body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol level,triglyceride level,low density lipoprotein cholesterol level,fasting blood glucose and C-reactive protein level in the case group were all higher than those in the control group,and high density lipoprotein cholesterol level lower than those of control group(P<0.05).The results of carotid plaque ultrasound examination showed that the number and score of ACP in the case group were significantly higher than those in the control group(P<0.01).There was significant difference in plaque properties between the two groups(P<0.05),and the number of unstable plaques in the case group was higher.Multivariate analysis showed that ACP score≥2,history of hypertension and diabetes,and elevated C-reactive protein level were independent risk factors for acute ischemic stroke(P<0.05).Conclusion ACP score≥2,history of hypertension and diabetes,and elevated C-reactive protein level are all independent risk factors for acute ischemic stroke,and these patients should be closely monitored in clinic.