踝肱指数与急性缺血性卒中患者早期神经功能恶化的相关性

摘要

目的：探讨踝肱指数(ankle-brachial index, ABI)与急性缺血性卒中患者早期神经功能恶化(early neurological deterioration, END)的相关性。方法连续纳入2014年1月至2014年12月期间在发病7 d内住院的急性缺血性卒中患者。采用双向多普勒血流探测仪检测 ABI。 END 定义为发病7 d内美国国立卫生研究院卒中量表评分总分增加≥2分或运动项目评分增加≥1分,确定并分析人口统计学特征、血管危险因素、实验室指标和 END 发生率。结果共纳入210例急性缺血性卒中患者,51例发生 END,159例未发生 END。单变量分析显示,END 组ABI≤0．9的患者构成比显著高于非 END 组(43．1%对22．0%；χ2=8．714,P =0．003)。多变量 logistic 回归分析显示,校正年龄、性别、基线收缩压和缺血性心脏病等混杂因素后,ABI≤0．9(优势比2．528,95%可信区间1．265~5．052；P =0．009)与急性缺血性卒中患者 END 独立相关。结论低 ABI 与急性缺血性卒中患者END 的发生有关。%Objective To investigate the correlation between ankle-brachial index (ABI) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset from January 2014 to December 2014 were enroled. Bidirectional Doppler flow detector was used to detect ABI. END was defined as the increased National Institutes of Health Stroke Scale score ≥2 or the increased motor score ≥1. The demographic characteristics, vascular risk factors, laboratory parameters, and the incidence of END were identified and analyzed. Results A total of 210 patients with acute ischemic stroke were enroled, including 51 had END and 159 did not have END. Univariate analysis showed that the proportion of patient with ABI ≤0. 9 of the END group was significantly higher than that of the non-END group (43. 1% vs. 22. 0% ; χ2 = 8. 714, P =0. 003). Multivariable logistic regression analysis showed that ABI ≤0. 9 (odds ratio 2. 688, 95% confidence interval 1. 265 - 5. 052; P = 0. 009) was independently associated with END in patients with ischemic stroke after adjusting for the confounding factors, such as age, sex, baseline systolic blood pressure, and ischemic heart disease. Conclusion The low ABI was associated with the occurrence of END in patients with acute ischemic stroke.