大动脉粥样硬化型脑梗死进展加重的危险因素

Risk Factors for Aggravated Progression of Large Atherosclerotic Cere⁃bral Infarction

目的探讨大动脉粥样硬化型脑梗死进展加重的危险因素。方法回顾性分析2022年2月—2023年5月邳州市人民医院在接诊的81例大动脉粥样硬化型脑梗死患者的临床资料,根据患者是否伴有进展加重分为两组:非进展组(n=42)和进展组(n=39)。分析大动脉粥样硬化型脑梗死进展加重的危险因素。结果两组颅内或颈动脉中重度狭窄、卒中相关肺部感染、载脂蛋白B与载脂蛋白A1的比值、单核细胞与高密度脂蛋白胆固醇的比值、同型半胱氨酸水平、脂蛋白相关磷脂A2、C反应蛋白、中性粒细胞百分比与淋巴细胞百分比的比值及尿酸水平比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,颅内或颈动脉中重度狭窄、卒中相关肺部感染、载脂蛋白B与载脂蛋白A1的比值、单核细胞与高密度脂蛋白胆固醇的比值、同型半胱氨酸、脂蛋白相关磷脂A2、C反应蛋白、中性粒细胞百分比与淋巴细胞百分比的比值及尿酸均是导致疾病进展的危险因素(OR=2.534、14.255、6.833、6.352、4.385、1.034、1.343、1.686、1.084,P<0.05)。结论大动脉粥样硬化型脑梗死的进展和加重与多种动脉粥样硬化相关的危险因素密切相关。在临床实践中,应及早关注这些相关指标,以便及时调整治疗方案,从而有效预防和控制大动脉粥样硬化型脑梗死的发生和进一步发展,以提高患者的预后。

Objective To investigate the risk factors of aggravated progression of large atherosclerotic cerebral infarc⁃tion.Methods Retrospective analysis was made on the clinical data of 81 patients with large atherosclerotic cerebral in⁃farction who were admitted by Pizhou People's Hospital from February 2022 to May 2023.According to whether the patients were accompanied by progression,they were divided into two groups:non progression group(n=42)and pro⁃gression group(n=39).Analyzed the risk factors of aggravation of cerebral infarction with atherosclerosis.Results The two groups were compared with severe stenosis of intracranial or carotid arteries,stroke associated pulmonary infec⁃tion,ratio of apolipoprotein B to apolipoprotein A1,ratio of monocytes to high-density lipoprotein cholesterol,homo⁃cysteine,lipoprotein associated phospholipid A2,C-reactive protein,ratio of neutrophil percentage to lymphocyte per⁃centage,and uric acid levels,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that severe stenosis of intracranial or carotid arteries,stroke associated pulmonary infection,ratio of apolipoprotein B to apolipoprotein A1,ratio of monocytes to high-density lipoprotein cholesterol,homocysteine,lipo⁃protein associated phospholipid A2,C-reactive protein,ratio of neutrophil percentage to lymphocyte percentage,and uric acid were all risk factors for disease progression(OR=2.534,14.255,6.833,6.352,4.385,1.034,1.583,1.343,1.686,P<0.05).Conclusion The progression and aggravation of large atherosclerotic cerebral infarction are closely re⁃lated to a variety of atherosclerotic risk factors.In clinical practice,early attention should be paid to these relevant in⁃dicators in order to adjust the treatment plan in time,so as to effectively prevent and control the occurrence and further development of large atherosclerotic cerebral infarction and improve the prognosis of patients.