国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
International Journal of Cerebrovascular Diseases
2015年
8期
597-601
,共5页
卒中%脑缺血%疾病恶化%时间因素%危险因素
卒中%腦缺血%疾病噁化%時間因素%危險因素
졸중%뇌결혈%질병악화%시간인소%위험인소
Stroke%Brain Ischemia%Disease Progression%Time Factors%Risk Factors
目的：探讨急性缺血性卒中患者早期神经功能恶化( early neurological deterioration, END)的危险因素。方法连续纳入发病24 h内的新发急性缺血性卒中患者,分为END组和非END组,比较两组患者的相关病史、基线临床资料、影像学检查和实验室检查结果。结果共纳入急性缺血性卒中患者95例,其中END组32例,非END组63例。两组之间糖尿病(χ2=6．081,P=0．014)、基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分>15分(χ2=9．851,P=0．002)、基线梗死体积>30 cm3(χ2=10．815,P=0．001)和发热(χ2=6．642,P=0．010)的患者构成比以及空腹血糖(t=2．632,P=0．010)、高半胱氨酸(t=2．997,P=0．003)、C反应蛋白(t=2．349,P=0．021)、基线NHISS评分(Z=497．5,P=0．001)、基线梗死体积(Z=544．5,P<0．001)差异存在统计学意义；此外,TOAST分型中大动脉粥样硬化性卒中(χ2=24．539,P<0．001)和小动脉闭塞性卒中(χ2=27．913,P<0．001)以及OSCP分型中完全前循环卒中(χ2=7．578,P<0．006)和部分前循环卒中(χ2=4．818,P<0．028)的患者构成比差异有统计学意义。多变量logistic回归分析显示,空腹血糖>6．0 mmol/L[优势比(odds ratio, OR)6．951,95%可信区间(confidence interval, CI)2．159~22．348；P=0．001]、高半胱氨酸>15μmol/L(OR 3．301,95% CI 1．028~10．595；P=0．045)、NIHSS评分>15分(OR 4．174,95% CI 1．172~14．870；P=0．028)、梗死体积>30 cm3(OR 4．996,95% CI 1．334~18．717；P=0．017)、发热(OR 4．538,95% CI 1．334~15．372；P=0．015)是急性缺血性卒中患者发生END的独立危险因素。结论基线血糖、NIHSS评分、梗死体积、高半胱氨酸和体温升高是急性缺血性卒中患者发生END的独立危险因素。
目的：探討急性缺血性卒中患者早期神經功能噁化( early neurological deterioration, END)的危險因素。方法連續納入髮病24 h內的新髮急性缺血性卒中患者,分為END組和非END組,比較兩組患者的相關病史、基線臨床資料、影像學檢查和實驗室檢查結果。結果共納入急性缺血性卒中患者95例,其中END組32例,非END組63例。兩組之間糖尿病(χ2=6．081,P=0．014)、基線美國國立衛生研究院卒中量錶(National Institutes of Health Stroke Scale, NIHSS)評分>15分(χ2=9．851,P=0．002)、基線梗死體積>30 cm3(χ2=10．815,P=0．001)和髮熱(χ2=6．642,P=0．010)的患者構成比以及空腹血糖(t=2．632,P=0．010)、高半胱氨痠(t=2．997,P=0．003)、C反應蛋白(t=2．349,P=0．021)、基線NHISS評分(Z=497．5,P=0．001)、基線梗死體積(Z=544．5,P<0．001)差異存在統計學意義；此外,TOAST分型中大動脈粥樣硬化性卒中(χ2=24．539,P<0．001)和小動脈閉塞性卒中(χ2=27．913,P<0．001)以及OSCP分型中完全前循環卒中(χ2=7．578,P<0．006)和部分前循環卒中(χ2=4．818,P<0．028)的患者構成比差異有統計學意義。多變量logistic迴歸分析顯示,空腹血糖>6．0 mmol/L[優勢比(odds ratio, OR)6．951,95%可信區間(confidence interval, CI)2．159~22．348；P=0．001]、高半胱氨痠>15μmol/L(OR 3．301,95% CI 1．028~10．595；P=0．045)、NIHSS評分>15分(OR 4．174,95% CI 1．172~14．870；P=0．028)、梗死體積>30 cm3(OR 4．996,95% CI 1．334~18．717；P=0．017)、髮熱(OR 4．538,95% CI 1．334~15．372；P=0．015)是急性缺血性卒中患者髮生END的獨立危險因素。結論基線血糖、NIHSS評分、梗死體積、高半胱氨痠和體溫升高是急性缺血性卒中患者髮生END的獨立危險因素。
목적：탐토급성결혈성졸중환자조기신경공능악화( early neurological deterioration, END)적위험인소。방법련속납입발병24 h내적신발급성결혈성졸중환자,분위END조화비END조,비교량조환자적상관병사、기선림상자료、영상학검사화실험실검사결과。결과공납입급성결혈성졸중환자95례,기중END조32례,비END조63례。량조지간당뇨병(χ2=6．081,P=0．014)、기선미국국립위생연구원졸중량표(National Institutes of Health Stroke Scale, NIHSS)평분>15분(χ2=9．851,P=0．002)、기선경사체적>30 cm3(χ2=10．815,P=0．001)화발열(χ2=6．642,P=0．010)적환자구성비이급공복혈당(t=2．632,P=0．010)、고반광안산(t=2．997,P=0．003)、C반응단백(t=2．349,P=0．021)、기선NHISS평분(Z=497．5,P=0．001)、기선경사체적(Z=544．5,P<0．001)차이존재통계학의의；차외,TOAST분형중대동맥죽양경화성졸중(χ2=24．539,P<0．001)화소동맥폐새성졸중(χ2=27．913,P<0．001)이급OSCP분형중완전전순배졸중(χ2=7．578,P<0．006)화부분전순배졸중(χ2=4．818,P<0．028)적환자구성비차이유통계학의의。다변량logistic회귀분석현시,공복혈당>6．0 mmol/L[우세비(odds ratio, OR)6．951,95%가신구간(confidence interval, CI)2．159~22．348；P=0．001]、고반광안산>15μmol/L(OR 3．301,95% CI 1．028~10．595；P=0．045)、NIHSS평분>15분(OR 4．174,95% CI 1．172~14．870；P=0．028)、경사체적>30 cm3(OR 4．996,95% CI 1．334~18．717；P=0．017)、발열(OR 4．538,95% CI 1．334~15．372；P=0．015)시급성결혈성졸중환자발생END적독립위험인소。결론기선혈당、NIHSS평분、경사체적、고반광안산화체온승고시급성결혈성졸중환자발생END적독립위험인소。
Objective To investigate the risk factors for early neurological deterioration (END) in patients with ischemic stroke. Methods The consecutive patients with new acute ischemic stroke within 24 h were enrol ed. They were divided into either an END or a non-END group. Their relevant medical history, baseline clinical data, imaging examinations and laboratory test results in both groups were compared. Results A total of 95 patients with acute ischemic stroke were enrol ed, including 32 in the END group and 63 in the non-END group. There were significant differences in the proportion of patients in diabetes mel itus (χ2 =6. 081, P=0. 014), baseline National Institutes of Health Stroke Scale (NIHSS) score >15 (χ2 =9. 851, P=0. 002), baseline infarct volume >30 cm3 (χ2 =10. 815, P=0. 001), and fever (χ2 =6. 642, P=0. 010), as wel as the fasting glucose (t=2. 632, P=0. 010), homocysteine (t =2. 997, P=0. 003), C-reactive protein (t=2. 349, P=0. 021), baseline NIHSS (Z=497. 5, P=0. 001), and baseline infarct volume (Z=544. 5, P<0. 001) between the 2 groups. Furthermore, there were significant differences in the proportions of patients in large artery atherosclerotic stroke (χ2 =24. 539, P<0. 001 ) and smal arterial occlusive stroke (χ2 = 27. 913, P< 0. 001 ) in the TOAST classification, as wel as the total anterior circulation stroke (χ2 =7. 578, P<0. 006) and partial anterior circulation stroke (χ2 =4. 818, P<0. 028) in the OSCP classification. Multivariate logistic regression analysis showed that fasting glucose >6. 0 mmol/L (odds ratio [OR] 6. 951, 95%confidence interval [CI] 2. 159-22. 348; P=0. 001), homocysteine >15 μmol/L (OR 3. 301, 95% CI 1. 028-10. 595; P=0. 045), NIHSS score >15 (OR 4. 174, 95% CI 1. 772-14. 870;P=0. 028), infarct volume >30 cm3 (OR 4. 996, 95% CI 1. 334-18. 717; P=0. 017), and fever (OR 4. 528, 95% CI 1. 334-15. 372;P=0. 015) were the independent risk factors for occurring END in patients with acute ischemic stroke. Conclusions The baseline glucose, NIHSS score, infarct volume, homocysteine, and increased body temperature are the independent risk factors for occurring EDN in patients with acute ischemic stroke.
