忻州市老年脑梗死预后影响因素分析

发布时间：2018-11-18 10:46

【摘要】：脑梗死是脑动脉短期内出现狭窄或闭塞,导致供应的脑组织发生缺血缺氧变性或死亡,出现相应的神经功能受损。脑梗死预后直接关系到患者生活质量。但是目前脑梗死预后的影响因素复杂,导致临床工作中对脑梗死患者预后的治疗及指导存在争议；而老年人通常就医不及时,伴发疾病多,病情复杂使预后较中青年人更差；忻州市有独特的地域特点,加之普遍对急性脑梗死的认识不足,导致忻州市老年脑梗死有其特殊性。本研究旨在对忻州市影响老年脑梗死预后的相关因素进行分析,对改善本市老年脑梗死预后提供理论依据。目的：分析忻州市老年脑梗死短期预后影响因素。方法：本研究采用横断面研究设计,纳入2011年12月-2013年6月197例发病72小时内入院的老年脑梗死患者。以改良Rankin量表(modify Rankin Scale, mRS)评分分为预后良好组和预后不良组。分析两组的个人特征(年龄、性别、吸烟、居住地)、既往史(冠心病、糖尿病、高血压病)、合并症(肺部感染)、NIHSS评分、空腹血糖、低密度脂蛋白、胱抑素、心电图。对老年脑梗死短期预后用MRS评分进行评估。对预后影响因素进行单因素分析,对单因素分析有统计学意义的变量进一步运用非条件logistic回归进行多因素分析。结果：单因素分析结果表明年龄、城乡差异、冠心病史、高血压病史、肺部感染、NIHSS评分、空腹血糖是影响老年脑梗死短期预后的独立危险因素(P)0.01)。房颤、低密度脂蛋白对老年脑梗死短期预后有影响(P0.05)。性别、吸烟、糖尿病史、胱抑素对老年脑梗死短期预后无影响(P0.05)。多因素分析结果发现,NIHSS评分、高血压病史、肺部感染对老年脑梗死短期预后有影响(P0.05),而年龄、城乡差异、空腹血糖、冠心病史、房颤、低密度脂蛋白对老年脑梗死短期预后无影响(P0.05)。结论：NIHSS评分、高血压病史是影响老年脑梗死短期预后的独立危险因素。肺部感染是影响老年脑梗死短期预后的重要危险因素,对这些危险因素进行积极干预可以改善忻州市老年脑梗死的预后。
[Abstract]:Cerebral infarction is a kind of cerebral artery stenosis or occlusion, which leads to ischemia and hypoxia degeneration or death of the supplied brain tissue, and the corresponding neurological impairment. The prognosis of cerebral infarction is directly related to the quality of life of patients. However, the factors influencing the prognosis of cerebral infarction are complicated, which leads to the controversy on the treatment and guidance of prognosis of patients with cerebral infarction in clinical work, while the elderly are usually not in time for medical treatment, accompanied by more diseases, and the complex condition makes the prognosis worse than that of young people. Xinzhou City has its unique regional characteristics, coupled with the general lack of understanding of acute cerebral infarction, leading to Xinzhou elderly cerebral infarction has its particularity. The purpose of this study was to analyze the factors related to the prognosis of senile cerebral infarction in Xinzhou City and to provide theoretical basis for improving the prognosis of senile cerebral infarction in Xinzhou City. Objective: to analyze the short-term prognostic factors of senile cerebral infarction in Xinzhou City. Methods: a cross-sectional study was conducted in 197 elderly patients with cerebral infarction admitted within 72 hours of onset from December 2011 to June 2013. The (modify Rankin Scale, mRS) score of modified Rankin scale was divided into good prognosis group and poor prognosis group. The personal characteristics (age, sex, smoking, residence), past history (coronary heart disease, diabetes, hypertension), complications (), NIHSS score of pulmonary infection, fasting blood glucose, low density lipoprotein, cystatin, electrocardiogram) were analyzed. The short-term prognosis of senile cerebral infarction was evaluated with MRS score. Univariate analysis of prognostic factors and multivariate analysis of unconditioned logistic regression were carried out for the variables with statistical significance in univariate analysis. Results: univariate analysis showed that age, urban and rural differences, history of coronary heart disease, history of hypertension, pulmonary infection, NIHSS score and fasting blood glucose were independent risk factors for short-term prognosis of cerebral infarction in elderly patients (P) 0.01). Atrial fibrillation and low density lipoprotein (LDL) had an effect on the short-term prognosis of senile cerebral infarction (P0.05). Sex, smoking, history of diabetes and cystatin had no effect on the short-term prognosis of cerebral infarction in the elderly (P0.05). Multivariate analysis showed that NIHSS score, history of hypertension and pulmonary infection had influence on short-term prognosis of cerebral infarction in the elderly (P0.05), but age, urban and rural differences, fasting blood glucose, history of coronary heart disease, atrial fibrillation, Low density lipoprotein had no effect on the short-term prognosis of cerebral infarction in the elderly (P0.05). Conclusion: NIHSS score and hypertension history are independent risk factors for short-term prognosis of senile cerebral infarction. Pulmonary infection is an important risk factor for the short-term prognosis of senile cerebral infarction. Active intervention of these risk factors can improve the prognosis of senile cerebral infarction in Xinzhou City.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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