复发性脑梗死患者发生早期神经功能恶化的相关危险因素分析

摘要

Objective To study the risk factors related to early neurological deterioration (END) in patients with recurrent cerebral infarction (RCI). Methods Three hundreds and twenty-six RCI patients admitted to our hospital from January 2014 to March 2015 were divided into END group (n = 66) and non-END group (n =260). The clinical and laboratory data were collected, and their cerebrovascular lesions were accessed according to the angiographic findings. Results (1) Single factor analysis showed the level of cholesterol was significantly higher in the END group than that of the non-END group (P < 0.05). The proportion of patients suffering from smoking, arterial occlusions, early onset stroke associated pneumonia (SAP) and hyponatremia was also higher in the END group (all P < 0.05). (2) Logistic regression analysis showed that arterial occlusions (OR = 2.137, 95%CI 1.093~4.181), SAP (OR=2.001, 95%CI 1.023~3.912) and hyponetremia (OR=2.467, 95%CI 1.217~ 5.000) were independent risk factors for END of RCI patients (all P < 0.05). Conclusion Arterial occlusions, SAP and hyponatremia may be used as predictors of the early development of RCI patients.%目的：探讨复发性脑梗死患者发生早期神经功能恶化（END）的相关危险因素。方法：回顾性分析2014年1月至2015年3月在我院住院治疗的复发性脑梗死患者326例，根据入院72 h内是否发生神经功能恶化分为END组66例和非END组260例。收集患者的临床资料和实验室指标，并根据脑血管检查结果，判断血管病变情况。结果：（1）单因素分析示，END组较非END组总胆固醇水平升高（P ＜0．05），吸烟、责任血管闭塞、早发卒中相关性肺炎及低钠血症的比例均显著升高（均P ＜0．05）；（2）Logistics回归分析显示，责任血管闭塞（OR ＝2．137，95％CI 1．093～4．181）、早发卒中相关性肺炎（OR ＝2．001，95％CI 1．023～3．912）及低钠血症（OR ＝2．467，95％CI 1．217～5．000）是复发性脑梗死患者发生END的独立危险因素（均P ＜0．05）。结论：责任血管闭塞、早发卒中相关性肺炎、低钠血症可作为复发性脑梗死患者发生END的预测指标。