61例非瓣膜性房颤并发急性脑梗塞的梗塞体积相关因素分析

发布时间：2018-04-23 12:33

本文选题：非瓣膜性房颤 + 脑梗塞体积　；参考：《吉林大学》2017年硕士论文

【摘要】：目的回顾性分析非瓣膜性房颤(Non-valvularartial fibrillation,NVAF)并发急性脑梗塞患者的梗塞体积与左心房内径、D-二聚体、平均血小板体积、动脉粥样硬化危险因素、入院及出院时基础状况之间的关系,以期发现可能作为预测非瓣膜性房颤并发严重脑梗塞的相关指标。方法选取2014年9月1日～2016年9月1日于吉林大学第二医院神经内科住院的急性脑梗塞患者,根据纳入排除标准,选取其中合并非瓣膜性房颤者。回顾入组患者的病历资料,收集其基本信息、既往疾病史、药物服用史、入院时基础状况、入院后生化指标、影像学检查结果及出院时基础状况。急性脑梗塞成像数据采用3.0TMRI检测,用ImageJ软件测量并计算脑梗塞体积。多元回归分析入组患者的脑梗塞体积与左心房内径、D-二聚体、平均血小板体积、动脉粥样硬化危险因素、入院及出院时基础状况的关系。结果本研究共纳入61例患者(男性36例,女性25例),年龄31～93岁,平均年龄为(70.9±11.4)岁,脑梗塞体积0.08～138.90ml,中位数为20.85ml。双变量相关分析显示脑梗塞体积与左心房内径(r=0.433,P=0.000)、D-二聚体(r=0.487,P==0.000)、平均血小板体积(r=0.397,P=0.002)、入院 NIHSS 评分(r=0.511,P==0.000)、出院NIHSS评分(r=0.412,P=0.000)成正相关,差异具有统计学意义。多元回归分析显示脑梗塞体积与左心房内径、D-二聚体、平均血小板体积显著相关(P=0.004、P=0.007、P=0.003),差异有统计学意义。结论1.NVAF并发急性脑梗塞的梗塞体积与左心房内径大小、D-二聚体水平、平均血小板体积水平与呈正相关。2.NVAF并发急性脑梗塞的梗塞体积与动脉粥样硬化危险因素如高血压、糖尿病、既往脑卒中或者TIA病史、吸烟等不相关。3.NVAF并发急性脑梗塞的梗塞体积与入院NIHSS评分呈正相关。4.左心房内径、D-二聚体、平均血小板体积有可能作为预测NVAF并发急性脑梗塞的梗塞体积的相关指标。
[Abstract]:Objective to retrospectively analyze the relationship between infarct volume and left atrial diameter D-dimer, mean platelet volume, risk factors of atherosclerosis, admission and discharge from patients with acute cerebral infarction in non-valvular atrial fibrillation non-valvular fibrillation (NVAFs). In order to find a possible predictor of non-valvular atrial fibrillation associated with severe cerebral infarction. Methods patients with acute cerebral infarction were selected from September 1, 2014 to September 1, 2016 in Department of Neurology, second Hospital of Jilin University. According to the exclusion criteria, patients with non-valvular atrial fibrillation were selected. The medical records of the patients were reviewed, and their basic information, history of past diseases, history of drug use, basic condition at admission, biochemical indexes after admission, imaging results and basic status at discharge were collected. The imaging data of acute cerebral infarction were measured by 3.0TMRI, and the volume of cerebral infarction was measured and calculated by ImageJ software. Multivariate regression analysis was used to analyze the relationship between cerebral infarction volume and D-dimer, mean platelet volume, risk factors of atherosclerosis, and basic condition at admission and discharge. Results A total of 61 patients (36 males and 25 females) were enrolled in this study. The mean age was 70.9 卤11.4 years, with a mean age of 70.9 卤11.4 years. The volume of cerebral infarction was 0.08 卤138.90 ml, the median was 20.85 ml. The bivariate correlation analysis showed that the volume of cerebral infarction was positively correlated with the left atrial diameter of 0.433P ~ (0.000) and the average platelet volume of 0.487 ~ 0.487 ~ 0.000 ~ 0.000g, the mean platelet volume was 0.397m ~ (0.000), the NIHSS score of admission was 0.511 ~ (0.000), and the NIHSS score was 0.412 ~ (0.000) (P = 0.000), and the difference was statistically significant (P < 0.05). Multiple regression analysis showed that the volume of cerebral infarction was significantly correlated with the diameter of D-dimer and the mean platelet volume of left atrium. Conclusion the infarct volume of 1.NVAF complicated with acute cerebral infarction is positively correlated with the level of D-dimer and the mean platelet volume. 2. The infarct volume of 1.NVAF complicated with acute cerebral infarction and the risk factors of atherosclerosis such as hypertension and diabetes mellitus. There was no correlation between previous stroke or TIA history, smoking and so on. 3. The infarct volume of NVAF complicated with acute cerebral infarction was positively correlated with the admission NIHSS score. 4. D- dimer and mean platelet volume of left atrium may be used as predictors of infarct volume in NVAF complicated with acute cerebral infarction.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R541.75

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