[1]贺东红,黄亮星△.大动脉粥样硬化性前循环脑梗死患者临床特征及预后影响因素分析*[J].陕西医学杂志,2020,49(7):800-803.[doi:DOI:10.3969/j.issn.10007377.2020.07.008]
　HE Donghong,HUANG Liangxing..Clinical characteristics and prognostic factors of patients with atherosclerotic anterior circulation cerebral infarction[J].,2020,49(7):800-803.[doi:DOI:10.3969/j.issn.10007377.2020.07.008]
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大动脉粥样硬化性前循环脑梗死患者临床特征及预后影响因素分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年7期
页码:
800-803
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Clinical characteristics and prognostic factors of patients with atherosclerotic anterior circulation cerebral infarction
作者:
贺东红; 黄亮星△
陕西省榆林市第二医院神经内科(榆林719000)
Author(s):
HE Donghong; HUANG Liangxing.
Department of Neurology,Yulin No.2 Hospital,Shaanxi Province(Yulin 719000)
关键词:
脑梗死;  前循环;  大动脉粥样硬化;  疾病特征;  预后;  危险因素
Keywords:
Cerebral infarction;  Anterior circulation;  Large artery atherosclerosis;  Disease characteristics;  Prognosis;  Risk factors
分类号:
R743.1
DOI:
DOI:10.3969/j.issn.10007377.2020.07.008
文献标志码:
A
摘要:
目的:探讨大动脉粥样硬化性前循环脑梗死(ACCI)患者的临床特征及可能影响其预后的相关因素。方法:选择106例ACCI患者为研究对象。收集患者性别、年龄、吸烟史、合并症(糖尿病、高血压)、既往病史、入院时临床特征、NIHSS评分、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL)、血尿酸、同型半胱氨酸(HCY)、纤维蛋白原(Fib)水平,记录继发肺部感染情况。依据发病后6个月时改良版Rankin(mRS)评分将患者分为预后良好组和预后不良组。Logistic回归分析法分析影响患者预后不良的相关因素。结果: ACCI患者主要临床特征为单侧肢体无力(51.89%)、单侧肢体麻木(48.11%)、意识障碍(20.75%)、大小便失禁(16.98%)。发病后6个月患者中预后不良占比40.57%。Logistic回归分析显示,患者年龄、入院时HbA1c、血尿酸、HCY、Fib及继发性肺部感染均是可能影响其预后的危险因素(P<0.05)。结论: ACCI发病容易引发单侧肢体无力、麻木、意识障碍和大小便失禁等症状,临床在ACCI防治中可将年龄、HbA1c、血尿酸、HCY、Fib作为判断ACCI风险和干预效果的指标。
Abstract:
Objective:To investigate the clinical features of patients with atherosclerotic anterior circulation cerebral infarction(ACCI)and related factors that may affect its prognosis. Methods:106 patients with ACCI were selected as subjects. The gender,age,smoking history,comorbidities(diabetes,hypertension),past medical history,clinical characteristics at admission,NIHSS score,the levels of glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),blood uric acid,homocysteine(HCY)and fibrinogen(Fib)were collected. The secondary pulmonary infection was recorded. Patients were divided into good prognosis group and poor prognosis group according to modified Rankin(mRS)score at 6 months after onset. Logistic regression analysis was used to analyze the related factors that caused the poor prognosis of patients. Results:The main clinical features of ACCI patients were unilateral limb weakness(51.89%),unilateral limb numbness(48.11%),disturbance of consciousness(20.75%),and urinary and fecal incontinence(16.98%). The proportion of patients with poor prognosis at 6 months after onset was 40.57%. Logistic regression analysis showed that age,HbA1c,serum uric acid,HCY,Fib and secondary pulmonary infection were risk factors that might affect their prognosis. Conclusion:The onset of ACCI is easy to cause unilateral limb weakness,numbness,disturbance of consciousness,and urinary and fecal incontinence. The age,HbA1c,serum uric acid,HCY and Fib can be used as indicators to judge ACCI risk and intervention effect clinically.

参考文献/References:

[1] 张淑君,石 磊. 大脑后循环缺血临床表现和治疗研究进展[J]. 陕西中医,2018,39(5):675-677.
[2] 吴婉玉,廖 峻,黄 劼,等. 急性前循环脑梗死患者血压变异性与颈动脉粥样硬化斑块的相关性[J]. 西部医学,2017,29(6):795-798.
[3] 王慧梅,鲁德甫,王智明,等. 对比超声增强评估颈动脉低回声斑块增强强度与前循环脑梗死的关系[J]. 安徽医药,2018,22(10):1953-1955.
[4] 耿 文,姜 亮,陈慧铀,等. 急性脑梗死磁共振扩散加权成像与TOAST分型、传统危险因素的关系探讨[J]. 磁共振成像,2018,9(6):465-471.
[5] 夏 峰. 颈部动脉粥样硬化超声特征在前、后循环脑梗死患者中的差异比较[D]. 乌鲁木齐:新疆医科大学.2016.
[6] 王 芳,蔺雪梅,王 清,等. 西安市后循环脑梗死患者临床特征和危险因素分析[J]. 陕西医学杂志,2016,45(6):720-721.
[7] 李自保,黄显军,吕 佳,等. 胚胎型大脑后动脉对大动脉粥样硬化性脑梗死预后的影响[J]. 中华神经医学杂志,2019,18(1):44-48.
[8] Haring R,Baumeister SE,Lieb W,et al. Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population[J]. Diabetes Research and Clinical Practice,2014,105(3):416-423.
[9] 王佳陪,景 丽,买 莉,等. 高血糖通过氧化损伤加重局灶性脑缺血再灌注神经元损伤[J]. 神经解剖学杂志,2014,30(4):413-418.
[10] 徐振宽. 钙池调控的钙离子内流在高血糖诱导的神经元损伤中的作用机制研究[D]. 济南:山东大学,2016.
[11] 韩西娟,孙永馨. 分支动脉粥样硬化病、腔隙性脑梗死的临床特征及其预后影响因素分析[J]. 山东医药,2016,56(20):82-83.
[12] 莫志铭. 尿酸在脑梗死中的神经保护作用机制研究[J]. 中国实用神经疾病杂志,2017,20(24):13-17.
[13] Mapoure YN,Mark AC,Doualla MS,et al. Serum uric acid is associated with poor outcome in black africans in the acute phase of stroke[J]. Stroke Research and Treatment,2017(5):1-9.
[14] 刘 颖. 脑梗死患者血浆脂联素和同型半胱氨酸水平与梗死严重程度及预后的关系[J]. 医学临床研究,2018,35(9):1776-1778.
[15] 赵日光,苏红军,鄂瑞芳,等. 前循环和后循环脑梗死危险因素的临床分析[J]. 中国全科医学,2017,20(12):117-119.
[16] 李慎军,程 明,唐吉刚,等. 急性脑梗死患者血纤维蛋白原水平与预后关系的研究[J]. 中华神经医学杂志,2016,15(2):177-182.
[17] 吴 钢,许映雪,胡志坚,等. 后循环脑梗死的相关危险因素及可能影响预后因素分析[J]. 中华神经医学杂志,2015,14(1):37-42.
[18] 夏树剑. 前循环、后循环急性脑梗死血浆纤维蛋白原的比较分析[J]. 心脑血管病防治,2011,11(2):121-123.
[19] 陈宇丹,胡文立,董 谦,等. 急性脑梗死患者并发肺部感染的危险因素和预后分析[J]. 山东医药,2016,56(26):93-94.
[20] 黄双丽,蒋燕萍. 前循环大面积脑梗死的临床特征及其预后的危险因素分析[J]. 实用医院临床杂志,2019,16(1):29-31.

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备注/Memo

备注/Memo:
*国家自然科学基金资助项目(81200512)
更新日期/Last Update: 2020-07-28