脑卒中患者血清同型半胱氨酸水平与其短期预后的关系
发布时间：2019-04-27 20:21
【摘要】：目的：脑卒中（Stroke）是全球的重大公共卫生问题，世界范围内脑卒中已成为第二大死亡原因和残疾的首要原因，它具有高发病率、高复发率、高致残率和高致死率的特点。脑卒中患者发病后短期内肢体瘫痪的康复最为关键，直接影响到远期预后，因此研究脑卒中患者住院期间预后的主要影响因素，并采取适当的预防措施，对患者的肢体瘫痪程度尤为重要，也为脑卒中的预防策略提供了新的依据。 本项研究利用脑卒中患者预后的回顾性队列，探讨同型半胱氨酸水平及传统危险因素与脑卒中患者住院期间结局的关系。 资料和方法：以2013年10月~2014年2月昆山市第一人民医院神经内科收治的386例脑卒中患者作为研究对象，收集患者的人口统计学信息、生活方式、临床特征、实验室检查、疾病史等资料。采用罗氏MODULAR_DP全自动生化分析仪检测患者入院24小时内同型半胱氨酸浓度。 在患者住院期间对其进行神经功能(NIHSS评分)和生活自理程度的评价(MRs评分)，以死亡、残疾(MRs≥3)作为研究结局。运用多因素logistic回归模型分析同型半胱氨酸水平及传统危险因素与住院期间结局的关系，计算OR和95%CI，并进行线性趋势检验。按照传统危险因素的不同水平将脑卒中患者分为若干亚组，进而分析同型半胱氨酸水平在每一亚组中与脑卒中患者预后的关联性。 结果：年龄≥65岁的患者住院期间发生不良结局的危险性是年龄＜65岁的患者的4.65倍（95%CI：1.90-11.34）；同血糖水平＜7.0mmol/L的患者相比，血糖水平≥7.0mmol/L的患者住院期间发生不良结局的OR(95%CI)是2.68（1.21，5.93）；舒张压≥100mmHg的患者住院期间发生不良结局的危险性是舒张压＜100mmHg的患者的4.54倍（95%CI：1.75-11.80）；同Hcy＜15μmol／L的患者相比，Hcy≥15μmol／L的患者住院期间发生不良结局的OR(95%CI)是1.0（50.50，，2.20）。年龄、血糖水平、舒张压水平与住院期间不良结局的发生存在剂量反应关系(P＜0.05)，而Hcy水平与住院期间不良结局风险之间无明显的剂量反应关系(P＞0.05)。 结论：1.年龄增大、入院时严重程度更高以及血糖、舒张压水平升高显著增加脑卒中患者住院期间不良结局发生的风险。2.年龄、血糖、血压水平升高与脑卒中患者短期预后均存在剂量反应关系。3.本研究结果未发现入院Hcy水平影响脑卒中患者住院期间结局。
[Abstract]:Aim: stroke (Stroke) is a major public health problem in the world. Stroke has become the second leading cause of death and disability worldwide. It has the characteristics of high incidence, high recurrence rate, high disability rate and high mortality. The rehabilitation of stroke patients within a short period of time after onset of stroke is the most important one, which directly affects the long-term prognosis. Therefore, the main factors affecting the prognosis of stroke patients during hospitalization are studied, and appropriate preventive measures are taken. It is especially important for the degree of limb paralysis and provides a new basis for the prevention strategy of cerebral apoplexy. In this study, a retrospective cohort was used to investigate the relationship between homocysteine levels and traditional risk factors and the outcome of stroke patients during hospitalization. Materials and methods: 386 stroke patients from the Department of Neurology of Kunshan first people's Hospital from October 2013 to February 2014 were selected to collect demographic information, lifestyle, clinical characteristics and laboratory tests. Medical history, etc. The concentration of homocysteine was measured by Roche-MODULAR_DP automatic biochemical analyzer within 24 hours after admission. The neurological function (NIHSS score) and self-care degree (MRs score) were evaluated during hospitalization. Death and disability (MRs 鈮
本文编号：2467280
[Abstract]:Aim: stroke (Stroke) is a major public health problem in the world. Stroke has become the second leading cause of death and disability worldwide. It has the characteristics of high incidence, high recurrence rate, high disability rate and high mortality. The rehabilitation of stroke patients within a short period of time after onset of stroke is the most important one, which directly affects the long-term prognosis. Therefore, the main factors affecting the prognosis of stroke patients during hospitalization are studied, and appropriate preventive measures are taken. It is especially important for the degree of limb paralysis and provides a new basis for the prevention strategy of cerebral apoplexy. In this study, a retrospective cohort was used to investigate the relationship between homocysteine levels and traditional risk factors and the outcome of stroke patients during hospitalization. Materials and methods: 386 stroke patients from the Department of Neurology of Kunshan first people's Hospital from October 2013 to February 2014 were selected to collect demographic information, lifestyle, clinical characteristics and laboratory tests. Medical history, etc. The concentration of homocysteine was measured by Roche-MODULAR_DP automatic biochemical analyzer within 24 hours after admission. The neurological function (NIHSS score) and self-care degree (MRs score) were evaluated during hospitalization. Death and disability (MRs 鈮
本文编号：2467280
本文链接：https://www.wllwen.com/yixuelunwen/shenjingyixue/2467280.html
最近更新
教材专著
