冠心病与后循环梗死的相关性及其对预后的影响

发布时间：2019-04-09 09:04

【摘要】：目的：探讨冠心病与后循环梗死的相关性及其对预后的影响。方法：本研究属于回顾性病例-对照研究，研究对象为2012年3月-2014年1月在新疆维吾尔自治区人民医院收治的急性脑梗死患者，，以年龄、性别匹配的正常体检者作为正常对照组。按照梗死部位将急性脑梗死分成后循环梗死组、前循环梗死组；按30天随访时mRS得分来分为预后不良组（3-6分）与预后良好组（0-2分）组。收集人口学资料、血管病危险因素和影像学资料，采用单因素和多因素logistic回归分析的方法，评估冠心病与脑梗死、前循环梗死和后循环梗死的相关性，评估前、后循环梗死不良预后的危险因素。结果：急性脑梗死371例，符合纳入标准343例，其中前循环梗死204例，后循环梗死139例。正常对照139例。前循环梗死组合并冠心病57例（27.94%），后循环梗死组合并冠心病40例（28.78%）。正常对照组诊断冠心病22例（15.82%）。多因素分析结果显示，后循环梗死的危险因素有冠心病（OR2.052，95%CI1.316-3.198，P=0.002）、高血压（OR3.539，95%CI1.955-6.405，P=0.001）、C反应蛋白（OR1.064，95%CI1.009-1.112，P=0.023）。随访30天时的mRS结果显示，后循环梗死组预后良好92例（66.18%），预后不良47例（33.8%）。影响后循环梗死预后的危险因素有冠心病（OR0.225，95%CI0.08-0.65，P0.01）、入院时NIHSS评分（OR8.702，95%CI3.51-21.58，P0.01）、入院时GCS（OR3.433，95%CI1.05-12.44，P=0.03）、脉压（OR0.469，95%CI0.2-0.95，P=0.037）。结论：后循环梗死的危险因素有冠心病、高血压和C反应蛋白。影响后循环梗死预后主要的因素包括：冠心病、脉压、GCS评分、NIHSS评分。
[Abstract]:Objective: To study the correlation between coronary heart disease and post-cycle infarction and its effect on prognosis. Methods: This study was a retrospective case-control study. The subjects of the study were the patients with acute cerebral infarction treated in the People's Hospital of Xinjiang Uygur Autonomous Region from March to January,2014. The normal physical examination with age and sex was used as the normal control group. The patients with acute cerebral infarction were divided into the following group (3-6) and the group (0-2) of the prognosis group according to the mRS score at 30-day follow-up. Demographic data, risk factors and imaging data were collected. The correlation between coronary heart disease and cerebral infarction, pre-circulating infarction and post-circulatory infarction was assessed by single-factor and multi-factor logistic regression, and the risk factors of the poor prognosis of the pre-and post-circulatory infarction were assessed. Results: In 371 cases of acute cerebral infarction, there were 343 cases of acute cerebral infarction, including 204 cases of pre-circulating infarction and 139 cases of post-circulatory infarction. The normal control was 139 cases. There were 57 cases (27.94%) of anterior circulation infarction, and 40 (28.78%) of coronary heart disease. In the normal control group,22 cases (15.82%) of coronary heart disease were diagnosed. Multivariate analysis showed that the risk factors of post-circulation infarction were coronary heart disease (ORR2.052,95% CI 1.316-3.198, P = 0.002), hypertension (OR3.539,95% CI,955-6.405, P = 0.001), and C-reactive protein (ORR1.064,95% CI1.009-1.112, P = 0.023). The results of mRS at 30 days of follow-up showed that the prognosis of the posterior circulation infarction group was good in 92 cases (66.18%) and the prognosis was poor (33.8%). There were coronary heart disease (OR0.225,95% CI 0.08-0.65, P0.01), NIHSS score (OR8.702,95% CI 3.51-21.58, P0.01) at admission, GCS (OR3.433,95% CI1.05-12.44, P = 0.03) and pulse pressure at admission (OR0.469,95% CI 0.2-0.95, P = 0.037). Conclusion: The risk factors of post-circulation infarction include coronary heart disease, hypertension and C-reactive protein. The factors that affect the prognosis of post-circulation infarction include coronary heart disease, pulse pressure, GCS score and NIHSS score.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3;R541.4

【参考文献】