CAJ | 학술논문

目的探讨急性脑梗死后全身炎症反应综合征(SIRS)及相关临床因素与预后的关系.方法采用前瞻性试验设计,对500例急性脑梗死患者进行SIRS及各相关因素调杏,并行单因素分析和Cox回归生存分析.结果 500例脑梗夕匕患者中SIRS 85例,其中完全前循环发生SIRS 31例;部分前循环34例,后循环15例;腔隙性梗死5例.脑梗死患者出现发热后,不同类型腑梗死SIRS发生率与病死率有较强的一致性(Spearman 1.0,P＜0.001).单因素分析年龄、感染、48h神经功能缺损评分,48h Glassgow评分、牛津郡社区卒中计划(OCSP)、吞咽困难、糖尿病为SIRS危险因素;SIRS为脑梗死后21d病死率的危险因素.Cox回归分析显爪脑梗死预后的独立危险凶素为48h Glassgow评分,SIRS人选方程,但P值＞0.05.结论急怀性脑梗死后SIRS及其相关危险因素与脑梗死21d内病死率显著相关,糖尿病脑梗死患者SIRS发牛率高.脑梗死患者出现发热后,不同OCSP分型脑梗死SIRS发生率与病死率有较强的一致性.
목적 탐토급성뇌경사후전신염증반응종합정(SIRS)급상관림상인소여예후적관계.방법 채용전첨성시험설계,대500례급성뇌경사환자진행SIRS급각상관인소조행,병행단인소분석화Cox회귀생존분석.결과 500례뇌경석비환자중SIRS 85례,기중완전전순배발생SIRS 31례;부분전순배34례,후순배15례;강극성경사5례.뇌경사환자출현발열후,불동류형부경사SIRS발생솔여병사솔유교강적일치성(Spearman 1.0,P＜0.001).단인소분석년령、감염、48h신경공능결손평분,48h Glassgow평분、우진군사구졸중계화(OCSP)、탄인곤난、당뇨병위SIRS위험인소;SIRS위뇌경사후21d병사솔적위험인소.Cox회귀분석현조뇌경사예후적독립위험흉소위48h Glassgow평분,SIRS인선방정,단P치＞0.05.결론 급부성뇌경사후SIRS급기상관위험인소여뇌경사21d내병사솔현저상관,당뇨병뇌경사환자SIRS발우솔고.뇌경사환자출현발열후,불동OCSP분형뇌경사SIRS발생솔여병사솔유교강적일치성.
Objective To investigate whether systemic inflammatory response syndrome(SIRS) after cerebral infarction is associated with poor outcome and its associated clinical factors.Methods We prospectively studied 500 patients with cerebral infarction.recorded the associated clinical factors on presentation and calculated the mortality at 21 st day.Results There are 85 SIRS patients in 500 patients with cerebral infarction,31 with total anterior cerebral infarction(TACI),34 with partial anterior cerebral infarction(PACI),15 with posterior cerebral infarction(POCI)and 5 with lacunar cerebral infarction (LACI).The frequency of SIRS was positively correlated with mortality rate according to Oxfordshire Commanity Stroke Project(OCSP)subtypes in cerebral infarction patients with fever(Spearman correlation coefficient=1.0:P＜0.001).Single factor analysis showed that the risk factors for both SIRS and mortality of cerebral infarction were as follows:age,infection,48h Chinese Stroke Scale score,48h Glassgow score,OCSP subtypes and dysphagia.Diabetes Was the risk factor for SIRS.but had no effect on mortality.On Cox regression,48h Glassgow score was the sole independent risk factor of outcome.However.if SIRS was included in the formula.P＞0.05.ConclusionsSIRS is the predictor of poor outcome after acute cerebral infarction.It is important to prevent SIRS especially in TACI and POCI.Diabetes is the risk factor for SIBS.but has no effect on mortality.