中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2012年
5期
343-346
,共4页
石玉芝%王春雪%李菁晶%边立衡%徐莹鑫%王拥军
石玉芝%王春雪%李菁晶%邊立衡%徐瑩鑫%王擁軍
석옥지%왕춘설%리정정%변립형%서형흠%왕옹군
年龄因素%卒中%预后
年齡因素%卒中%預後
년령인소%졸중%예후
Age factors%Stroke%Prognosis
目的 探讨高龄急性缺血性卒中患者3个月预后及其影响因素.方法 305例年龄≥65岁急性缺血性卒中住院患者纳入研究.依据年龄将患者分为:高龄组78例(≥80岁)和老年组227例(65~ 79岁).卒中后(90 ±7)d随访功能预后.结果 高龄组比老年组患者3个月预后更差,两组预后不良患者[改良Rankin量表(mRS)=3~6分]比例为56.41%比41.40% (P =0.015).Logistic回归分析显示白蛋白(OR 0.73,95% C10.55 ~0.95)、入院时美国国立卫生院神经功能缺损评分(NIHSS)(OR 1.48,95% CI1.19 ~1.83)是高龄患者预后不良的影响因素.结论 ≥80岁急性缺血性卒中患者3个月功能预后更差.入院NIIISS高、白蛋白水平低是高龄组缺血性卒中患者3个月功能预后不良的预测因素.
目的 探討高齡急性缺血性卒中患者3箇月預後及其影響因素.方法 305例年齡≥65歲急性缺血性卒中住院患者納入研究.依據年齡將患者分為:高齡組78例(≥80歲)和老年組227例(65~ 79歲).卒中後(90 ±7)d隨訪功能預後.結果 高齡組比老年組患者3箇月預後更差,兩組預後不良患者[改良Rankin量錶(mRS)=3~6分]比例為56.41%比41.40% (P =0.015).Logistic迴歸分析顯示白蛋白(OR 0.73,95% C10.55 ~0.95)、入院時美國國立衛生院神經功能缺損評分(NIHSS)(OR 1.48,95% CI1.19 ~1.83)是高齡患者預後不良的影響因素.結論 ≥80歲急性缺血性卒中患者3箇月功能預後更差.入院NIIISS高、白蛋白水平低是高齡組缺血性卒中患者3箇月功能預後不良的預測因素.
목적 탐토고령급성결혈성졸중환자3개월예후급기영향인소.방법 305례년령≥65세급성결혈성졸중주원환자납입연구.의거년령장환자분위:고령조78례(≥80세)화노년조227례(65~ 79세).졸중후(90 ±7)d수방공능예후.결과 고령조비노년조환자3개월예후경차,량조예후불량환자[개량Rankin량표(mRS)=3~6분]비례위56.41%비41.40% (P =0.015).Logistic회귀분석현시백단백(OR 0.73,95% C10.55 ~0.95)、입원시미국국립위생원신경공능결손평분(NIHSS)(OR 1.48,95% CI1.19 ~1.83)시고령환자예후불량적영향인소.결론 ≥80세급성결혈성졸중환자3개월공능예후경차.입원NIIISS고、백단백수평저시고령조결혈성졸중환자3개월공능예후불량적예측인소.
Objective To investigate the clinical characteristics,3-month outcome and predictive factors in the very elderly patients with ischemic stroke.Methods A total of 305 acute ischemic patients aged 65 years and over were enrolled in the study.They were divided into two subgroups by age:80 years old and over(n =78),65-79 years old(n =227).The clinical outcome was assessed by the modified Rankin Scale (mRS) on (90 ± 7 ) days after stroke,and categorized as good ( scoring 0-2 ) or poor( scoring 3-6) outcome.Results Significantly lower BMI [ ( 23.62 ± 4.92 ) kg/m2 vs ( 25.08 ± 3.69 ) kg/m2,P =0.005],lower frequency of dyslipidemia(56.41% vs 71.13%,P =0.006) and alcohol intake (0% vs 6.61%,P =0.043 )were found in the very elderly group.The rates of poor functional outcome in the ≥ 80years group and the 65-79 years old group were 56.41% (44/76) and 41.40% (94/224) respectively,with a P value of 0.015.Multivariate logistic regression analysis showed that higher National Institute of Health stroke scale (NItISS) total score (OR 1.48,95% CI 1.19-1.83 ) and lower albumin level (OR 0.73,95 % CI 0.55 -0.95 ) were associated with poor outcome in ≥ 80 year old,whereas higher NIHSS total score ( OR 1.38,95% CI 1.24-1.53) and complications during hospital stay ( OR 2.58,95% CI 1.07-6.19 ) were predictive factors in the 65-79 years old group.Conclusion Our study suggests that NIHSS scores,albumin level and complications during hospitalization are useful predictive factors for the short-term poor functional outcome in the patients of ≥65 years old and ≥80 years old patients have a worse prognosis.