高海拔地区进展性脑梗死发生率、病因分型及相关因素分析

发布时间：2018-09-09 13:12

【摘要】：目的探讨高海拔地区进展性脑梗死的发生率、病因分型及相关危险因素。方法采用前瞻性研究方法,连续收集2014年5月-2017年5月青海省人民医院神经内科急性脑梗死病例共1200例,采用美国国立卫生研究院卒中量表(NIHSS)评分与Glasgow昏迷评定量表(GCS)评分,分析进展性脑梗死发生率,同时进行病因分型,分析各亚型所占比例,并明确相关危险因素。结果 (1)进展性脑梗死的发生率为19%(228/1200),其中大动脉粥样硬化性卒中(LAA)占31.6%(72/228),心源性栓塞(CE)占28.9%(66/228),小动脉闭塞性卒中(SAO)占18.9%(43/228),其他原因(OE)占15.8%(36/228),原因不明型(UE)占4.8%(11/228)。(2)对两组各因素行χ2检验或t检验,发现房颤病史、高血压病史、糖尿病史、脑卒中病史、大动脉病变、血清同型半胱氨酸浓度(Hcy)、血红蛋白浓度;冬季、感染、吸烟、年龄等两组间比较差异有统计学意义(P0.05,P0.01)。进一步做多因素Logistic回归分析显示,高血压病史、糖尿病史、大动脉病变、房颤病史、血清同型半胱氨酸浓度(Hcy)、血红蛋白浓度等6个因素与脑梗死进展有显著相关。结论高海拔地区进展性脑梗死发生率较高,大动脉粥样硬化性脑梗死最易发生进展,相关危险因素为高血压病史、糖尿病史、大动脉病变、房颤病史、血清同型半胱氨酸浓度(Hcy)、血红蛋白浓度。
[Abstract]:Objective to investigate the incidence, etiological classification and risk factors of progressive cerebral infarction at high altitude. Methods 1200 patients with acute cerebral infarction in Department of Neurology of Qinghai Provincial people's Hospital from May 2014 to May 2017 were collected by prospective study. (NIHSS) score of stroke scale and (GCS) score of Glasgow coma rating scale were used. The incidence of progressive cerebral infarction was analyzed, the etiological classification, the proportion of subtypes were analyzed, and the related risk factors were identified. Results (1) the incidence of progressive cerebral infarction was 19% (228 / 1200), of which (LAA) was 31.6% (72 / 228), (CE) was 28.9% (66 / 228), (SAO) was 18.9% (43 / 228), (OE) for other reasons was 15.8% (36 / 228), unknown (UE) was 4.8% (11228 / 228) for both groups. 蠂 2 test or t test, It was found that the history of atrial fibrillation, hypertension, diabetes, stroke, arteriopathy, serum homocysteine concentration of (Hcy), hemoglobin, winter, infection, smoking, age were significantly different between the two groups (P0.05, P0.01). Further multivariate Logistic regression analysis showed that 6 factors, such as history of hypertension, diabetes, arteriopathy, atrial fibrillation, serum homocysteine concentration, (Hcy), hemoglobin concentration, were significantly correlated with the progression of cerebral infarction. Conclusion the incidence of progressive cerebral infarction is high in high altitude area, and atherosclerotic cerebral infarction is most likely to develop. The related risk factors are hypertension, diabetes, arteriopathy and atrial fibrillation. Serum homocysteine concentration (Hcy), hemoglobin concentration.
【作者单位】：青海省人民医院神经内科;
【基金】：青海省科技厅攻关项目(2014-NS-120-1) 青海省卫生计生委科研基金项目[青卫科(2015)18号]
【分类号】：R743.33

【相似文献】