颈动脉狭窄下缺血性卒中患者近期生存状况对比

摘要

目的：对比不同病情症状性颈动脉狭窄下缺血性卒中患者近期生存状况。方法选择北京301总医院合作医院涿州市医院2012年1月至2014年3月缺血性脑卒中患者325例，根据颈动脉狭窄程度分为重度颈动脉狭窄28例，中度狭窄27例，轻度或无狭窄270例。采用多元线性Logistic回归分析方法分析不同病情症状性颈动脉狭窄下缺血性卒中患者生存状况。结果重度狭窄组患者病死率更高、神经功能恶化程度更大、不良转归比例更大、住院时间延长，与其他两组差异均有统计学意义。多元Logistic回归分析显示，与中度狭窄组比较，重度狭窄组患者死亡风险更高（OR＝2．319，95％ CI＝1．989～4．227），神经功能恶化（OR＝1．426，95％ CI＝1．317～1．953）、不良转归更严重（OR＝1．350，95％ CI＝1．231～1．423）和住院时间延长（OR＝1．328，95％ CI＝1．166～1．445）。结论颈动脉狭窄尤其是重度颈动脉狭窄患者短期生存状况最差，症状性颈动脉狭窄是缺血性脑卒中短期预后的独立危险因素，因此，针对症状性颈动脉重度狭窄患者应尽早采取积极的干预措施。%Objective To contrast the different symptomatic carotid artery stenosis on short‐term outcome in ischemic stroke patients. Methods A total of 325 AIS patients were divided into severe carotid artery stenosis group (n=28), moderate carotid artery stenosis group (n=27), mild or noncarotid artery stenosis group (n=270). All the patients were all from January 2012 to March 2014 in our hospital. Relation between severity of carotid artery steno‐sis and short‐term outcome of AIS was assessed by Logistic regression analysis. Results The risk of death, neurolog‐ical function deterioration and poor prognosis was greatest, and the hospital stay time was longest in severe carotid artery stenosis group, the differences were statistically significant. Multivariate Logistic regression analysis showed that, compared with moderate carotid artery stenosis group, the mortality was higher(OR=2. 319, 95% CI=1. 989-4. 227), the neurological function deterioration (OR= 1. 426, 95% CI= 1. 317~1. 953)was severer, the prognosis (OR=1. 350, 95% CI=1. 231-1. 423) was poorer, and the hospital stay time (OR=1. 328, 95% CI=1. 166-1. 445) was longer in severe carotid artery stenosis group. Conclusion Carotid stenosis, especially short‐term survival in pa‐tients with severe carotid artery stenosis is the worst conditions. Symptomatic severe carotid artery stenosis is an in‐dependent predictor for the poor short‐term outcome in AIS patients. Active intervention measures should thus be taken as early as possible for it.