大脑中动脉供血区急性脑梗死患者早期神经功能恶化危险因素分析

发布时间：2018-01-30 12:46

  本文关键词： 脑梗死 侧支循环 危险因素 早期神经功能恶化　出处：《中国脑血管病杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨大脑中动脉供血区急性脑梗死患者早期神经功能恶化(END)的危险因素。方法回顾性连续纳入2009年1月至2012年12月于南京军区南京总医院神经内科住院的大脑中动脉供血区急性脑梗死并完成全脑DSA检查的患者81例。END定义为入院72 h内美国国立卫生研究院卒中量表(NIHSS)评分较入院基线评分增加≥2分或运动评分项增加≥1分。将所有患者根据是否发生END分为END组26例和非END组55例,采用单因素分析两组间临床资料的差异,侧支循环分级标准采用美国介入治疗神经放射学学会/介入放射学学会侧支循环评估系统。采用多因素Logistic回归分析大脑中动脉供血区急性脑梗死发生END的危险因素。结果与非END组比较,END组患者年龄≥60岁[65.4%(17/26)比36.4%(20/55);χ~2=5.992,P=0.014]、超敏C反应蛋白水平≥4.0 mg/L[76.9%(20/26)比45.5%(25/55);χ~2=7.080,P=0.008]及糖尿病患者比例[38.5%(10/26)比16.4%(9/55);χ~2=4.802,P=0.028]均显著升高,而侧支循环分级显著降低(Z=-3.253,P0.01)。多因素Logistic回归分析显示,年龄≥60岁(OR=3.412,95%CI:1.075~10.824;P=0.037)、超敏C反应蛋白水平≥4.0 mg/L(OR=3.812,95%CI:1.141~12.740;P=0.030)及侧支循环分级(OR=2.165,95%CI:1.241~5.514;P=0.009)为大脑中动脉供血区急性脑梗死发生END的独立危险因素。结论大脑侧支循环分级下降和年龄≥60岁、超敏C反应蛋白水平≥4.0 mg/L是大脑中动脉供血区急性脑梗死发生END的独立危险因素。
[Abstract]:Objective to investigate the early deterioration of neural function in patients with acute cerebral infarction in the middle cerebral artery (MCA) region. Methods from January 2009 to December 2012, acute cerebral infarction in the middle cerebral artery (MCA) supplying area was continuously included in the department of neurology, Nanjing general hospital of Nanjing military region, Nanjing military region from January 2009 to December 2012, and the whole brain DSA examination was completed. 81 cases examined. End defined as admission 72. The National Institutes of Health Stroke scale within h (NIH). All patients were divided into END group (n = 26) and non-#en2# group (n = 55) according to the occurrence of END. Univariate analysis was used to analyze the difference of clinical data between the two groups. The classification of collateral circulation was evaluated by the American Society of Interventional Radiology / Society of Interventional Radiology. Multivariate Logistic regression Analysis of Acute Cerebral Infarction in the Middle Cerebral artery. The risk factors of END were compared with those in non-#en1# group. Age 鈮，

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