急性脑梗死再灌注治疗后患者发生早期神经功能恶化的影响因素

Influencing factors of early neurological deterioration in patients with acute cerebral infarction after reperfusion

目的:分析急性脑梗死再灌注治疗后患者发生早期神经功能恶化的影响因素。方法:回顾性分析2021年4月至2022年6月该院收治的121例急性脑梗死患者的临床资料,统计急性脑梗死再灌注治疗后患者早期神经功能恶化的发生情况,采用Logistic回归分析急性脑梗死再灌注治疗后患者发生早期神经功能恶化的影响因素。结果:根据急性脑梗死再灌注治疗后患者是否发生早期神经功能恶化分为恶化组37例和非恶化组84例;恶化组合并糖尿病、责任大血管闭塞、白细胞计数>9.15×10^(9)/L、治疗前NIHSS评分≥12分、昏迷、合并吞咽障碍、心源性脑栓塞占比均高于非恶化组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,合并糖尿病、责任大血管闭塞、治疗前NIHSS评分≥12分、昏迷、合并吞咽障碍、心源性脑栓塞、白细胞计数>9.15×10^(9)/L均为影响急性脑梗死再灌注治疗后患者发生早期神经功能恶化的危险因素(OR>1,P<0.05)。结论:合并糖尿病、责任大血管闭塞、治疗前NIHSS评分≥12分、昏迷、合并吞咽障碍、心源性脑栓塞、白细胞计数>9.15×10^(9)/L均为影响急性脑梗死再灌注治疗后患者发生早期神经功能恶化的危险因素。

Objective:To analyze influencing factors of early neurological deterioration in patients with acute cerebral infarction after reperfusion.Methods:The clinical data of 121 patients with acute cerebral infarction admitted to this hospital from April 2021 to June 2022 were retrospectively analyzed.The incidence of early neurological deterioration in these patients with acute cerebral infarction after reperfusion was statistically analyzed.Logistic regression was used to analyze the influencing factors of early neurological deterioration in the patients with acute cerebral infarction after reperfusion.Results:According to whether early neurological deterioration occurred in the patients with acute cerebral infarction after reperfusion,they were divided into deterioration group(37 cases)and non-deterioration group(84 cases).The proportions of the patients with combined diabetes,responsible large vessel occlusion,white blood cell count>9.15×10^(9)/L,NIHSS score≥12 before the treatment,coma,combined dysphagia and cardiogenic cerebral embolism in the deterioration group were higher than those in the non-deterioration group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed combined diabetes,responsible large vessel occlusion,NIHSS score≥12 before the treatment,coma,combined dysphagia,cardiogenic cerebral embolism white blood cell count>9.15×10^(9)/L were all risk factors for early neurological deterioration in the patients with acute cerebral infarction and reperfusion.Conclusions:Combined diabetes,responsible large vessel occlusion,NIHSS score≥12 before the treatment,coma,combined dysphagia,cardiogenic cerebral embolism white blood cell count>9.15×10^(9)/L are the risk factors for early neurological deterioration in the patients with acute cerebral infarction and reperfusion.