CAJ | 학술논문

目的：探讨进展性脑卒中的影响因素，为临床提供参考。方法选择2011年1月-2013年6月在我科住院的进展性脑卒中患者27例作为研究组，非进展性脑卒中患者49例作为对照组。回顾性分析两组患者的既往史和个人史，生化指标，发热情况及颈动脉狭窄程度、斑块情况，同时分析研究组患者颅脑 MRI 和/或 MRA 检查结果。结果研究组患者糖尿病病史阳性率高于对照组（P <0.05）；两组患者高血压、脑卒中、冠心病病史及吸烟、饮酒史阳性率比较，差异均无统计学意义（P >0.05）。研究组患者空腹血糖高于对照组，高密度脂蛋白胆固醇低于对照组（P <0.05）；两组患者总胆固醇、三酰甘油、低密度脂蛋白胆固醇、同型半胱氨酸、纤维蛋白原、血尿酸比较，差异均无统计学意义（P >0.05）。研究组患者颈动脉不稳定斑块检出率高于对照组（P <0.05）；两组患者发热率、颈动脉狭窄率比较，差异均无统计学意义（P >0.05）。颅脑 MRI 检查结果示，研究组患者梗死灶多位于基底核区，其中前循环梗死18例、后循环梗死4例、多发腔隙性梗死5例；8例患者颅脑 MRA 检查示血管狭窄，其中大脑中动脉狭窄5例、大脑前动脉狭窄2例、大脑后动脉狭窄1例。结论有糖尿病病史、空腹血糖升高、高密度脂蛋白胆固醇降低及颈动脉不稳定斑块是进展性脑卒中的主要影响因素，临床上应重视合并上述影响因素的脑卒中患者。
목적：탐토진전성뇌졸중적영향인소，위림상제공삼고。방법선택2011년1월-2013년6월재아과주원적진전성뇌졸중환자27례작위연구조，비진전성뇌졸중환자49례작위대조조。회고성분석량조환자적기왕사화개인사，생화지표，발열정황급경동맥협착정도、반괴정황，동시분석연구조환자로뇌 MRI 화/혹 MRA 검사결과。결과연구조환자당뇨병병사양성솔고우대조조（P <0.05）；량조환자고혈압、뇌졸중、관심병병사급흡연、음주사양성솔비교，차이균무통계학의의（P >0.05）。연구조환자공복혈당고우대조조，고밀도지단백담고순저우대조조（P <0.05）；량조환자총담고순、삼선감유、저밀도지단백담고순、동형반광안산、섬유단백원、혈뇨산비교，차이균무통계학의의（P >0.05）。연구조환자경동맥불은정반괴검출솔고우대조조（P <0.05）；량조환자발열솔、경동맥협착솔비교，차이균무통계학의의（P >0.05）。로뇌 MRI 검사결과시，연구조환자경사조다위우기저핵구，기중전순배경사18례、후순배경사4례、다발강극성경사5례；8례환자로뇌 MRA 검사시혈관협착，기중대뇌중동맥협착5례、대뇌전동맥협착2례、대뇌후동맥협착1례。결론유당뇨병병사、공복혈당승고、고밀도지단백담고순강저급경동맥불은정반괴시진전성뇌졸중적주요영향인소，림상상응중시합병상술영향인소적뇌졸중환자。
Objective To investigate the risk factors of progressive stroke,to provide references for clinic. Methods From January 2011 to June 2013,27 patients with progressive stroke in our hospital were enrolled as observation group,49 pa-tients with non - progressive stroke as control group. Past medical history and personal history,biochemical index,incidence of fever,stenosis and plaques of carotid artery between the two groups were compared,and brain MRI/ MRA examination results of observation group was retrospectively analyzed. Results Positive rate of diabetes history of observation group was higher than that of control group(P < 0. 05),while there was no significant differences of positive rates of hypertension history,stroke histo-ry,coronary heart disease history,smoking history and drinking history between the two groups( P > 0. 05). Fasting plasma glucose(FPG)of observation group was higher,high density lipoprotein cholesterol(HDL - C)was lower than that of control group,respectively(P < 0. 05),while there was no significant differences of total cholesterol(TC),triacylglycerol,low den-sity lipoprotein cholesterin(LDL - C),homocysteine,fibrinogen,uric acid between the two groups(P > 0. 05). Incidence of unstable plaques of carotid artery of observation group was higher than that of control group(P < 0. 05),while there was no sig-nificant differences of incidence of fever and carotid artery stenosis between the two groups(P > 0. 05). Brain MRI examination results showed that,infarction positions were mostly located in basal ganglia area,including 18 cases with anterior circulation in-farction,4 cases with posterior circulation infarction,5 cases with multiple lacunar infarction. Brain MRA examination results showed angiostenosis in 8 cases,including 5 cases with middle cerebral artery stenosis,2 cases with anterior cerebral artery ste-nosis,1 case with posterior cerebral artery stenosis. Conclusion The major influencing factors of progressive stroke includes di-abetes history,higher FPG,lower HDL - C and unstable plaques of carotid artery,clinicians should pay more attention to stoke patients with above influencing factors.