进展性脑梗死患者预后相关因素分析

摘要

Objective:To identify the predictors correlated with the prognosis 90 days after acute progressive ischemic stroke. Methods:One hundred and fifty-five acute progressive ischemic stroke patients within 24 hours after onset were enrolled into the study during Feb. 2011 to Dec. 2012. The demographic data, past history, laboratory examination and imaging studies were recorded. The neurologic deficit scores at admission to hospital,symptomatic progression period and 90 days’period were assessed using U. S National Institutes of Health stroke scale( NIHSS) ,Glasgow coma scale( GCS) and modified Rankin scale( mRS) . Results:There were statistical significant differences about C reactive protein within 24 hours,blood glucose level,fibrinogen,erythrocyte sedimentation rate,baseline GCS and NIHSS scores and hospitalization infection in patients at 90 days mRS clinical outcome(P<0. 05 to P<0. 01). Conclusions:The factors including C reactive protein,blood glucose level,fibrinogen,erythrocyte sedimentation rate,GCS and NIHSS scores,infection were correlated with 90 days mRS clinical outcome. In clinical treatment,control these factors can improve the outcome.%目的：研究进展性脑梗死患者90 d预后的相关因素。方法：采用前瞻性队列研究，自2011年2月至2012年12月，共连续入选发病24 h入院并有进展的脑梗死患者155例。患者入院时收集人口学资料、既往病史、实验室检查、影像学检查，并记录入院、症状进展及发病90 d的神经功能评分：美国国立卫生院卒中评分( NIHSS )、格拉斯哥昏迷评分( GCS )、改良的Rankin评分( mRS)。结果：发病24 h内C反应蛋白、血糖、纤维蛋白原、红细胞沉降率、基线水平GCS和NIHSS、住院期间发生感染在患者90 d mRS临床结局间差异均有统计学意义(P<0.05~P<0.01)。结论：进展性脑梗死患者基线的C反应蛋白、血糖、纤维蛋白原、红细胞沉降率、基线水平GCS和NIHSS、感染、与患者90 d mRS临床结局均具有一定关系，控制某些因素有可能改善预后。