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1.
目的 研究探讨动脉瘤性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)继发症状性脑血管痉挛
(symptomatic cerebral vasospasm,SCVS)的相关危险因素,为SCVS的防治提供参考。
方法 回顾性分析96例SAH患者临床资料,对性别、年龄、高血压史、糖尿病史、Fisher分级等影响因
素进行统计学分析。
结果 96例患者中发生SCVS的患者共39例,单因素分析结果显示SCVS组与非SCVS组在年龄、高血
压、吸烟、脑室内积血、Hunt-Hess分级、Fisher分级、数字减影血管造影(digital subtraction angiography,
DSA)显示血管痉挛程度、尼莫地平使用等方面差异有显著性;多因素Logistic回归分析结果显示:低
龄、高血压史、Fisher分级是发生SCVS的危险因素,其比值比(odds ratio,OR)分别为0.567、1.982和
2.713;而尼莫地平的使用是SCVS发生的保护因素,OR为0.799。
结论 SAH后SCVS是多种因素共同作用的结果,其中低年龄、高血压史、Fisher分级是SCVS的独立危
险因素,尼莫地平使用为保护因素。  相似文献   

2.
目的对比分析外伤性与动脉瘤性蛛网膜下腔出血发生脑血管痉挛的危险因素。方法收集50例外伤性蛛网膜下腔出血(TSAH)和72例动脉瘤性蛛网膜下腔出血(ASAH)的临床资料,采用单因素分析法及多因素Logistic回归分析法分析两组患者发生脑血管痉挛(CVS)的危险因素。结果TSAH患者体温,白细胞计数和舒张压水平均高于ASAH患者(P=0.041;P=0.005;P=0.000)。单因素分析发现高血压和Fisher分级对TSAH组发生CVS有显著影响(P=0.031;P=0.012);吸烟,二次出血,Fisher分级及Hunt-Hess分级对ASAH组发生CVS有显著影响(P=0.044;P=0.002;P=0.025;P=0.010);多因素Logistic回归分析发现对于TSAH患者,仅Fisher分级是CVS的危险因素(OR=0.237,95%CI 0.065-0.857,P=0.028);对于ASAH患者,二次出血(OR=12.035,95%CI 1.645-88.028,P=0.014),Fisher分级(OR=0.200,95%CI 0.056-0.717,P=0.013)和Hunt-Hess分级(OR=0.259,95%CI 0.073-0.919,P=0.037)是发生CVS的危险因素。结论对于TSAH患者,仅Fisher分级是发生CVS的危险因素;而对于ASAH患者,其发生CVS的危险因素包括二次出血,Fisher分级和Hunt-Hess分级。  相似文献   

3.
目的探讨和分析颅内动脉瘤性蛛网膜下腔出血患者手术前病情加重的相关危险因素。方法选择2002年5月-2006年3月诊断明确的189例动脉瘤性蛛网膜下腔出血患者,均于首次发病后2周内接受手术治疗。根据手术前Hunt-Hess分级分为颅内动脉瘤手术前病情加重组(27例)和手术前病情未加重组(162例)。通过Logistic回归方程对11项与蛛网膜下腔出血相关的危险因素进行分析,从中归纳总结出与手术前病情加重最为相关的危险因素。结果颅内动脉瘤性蛛网膜下腔出血首诊Hunt-Hess分级(OR=2.739,95%CI:1.721~4.359;P=0.000)、意识障碍(OR=4.863,95%CI:1.687~14.020;P=0.003)和运动功能障碍(OR=3.579,95%CI:1.064~12.042;P=0.039)等3项因素与动脉瘤性蛛网膜下腔出血患者手术前病情加重相关;而与性别、年龄、失语、脑积水、脑内或脑室出血及高血压病史等因素无关,两组相比差异无统计学意义(P>0.05)。结论首诊Hunt-Hess分级≥3级、意识障碍和运动功能障碍等项指标可以作为预测动脉瘤性蛛网膜下腔出血患者手术前病情加重的独立危险因素,对预测患者病情的变化具有重要临床意义。  相似文献   

4.
目的 探讨动脉瘤性蛛网膜下腔出血后脑血管痉挛的危险因素.方法 回顾性分析93例动脉瘤性蛛网膜下腔出血患者的临床资料,研究脑血管痉挛的危险因素.结果 93例动脉瘤性蛛网膜下腔出血患者中共有28例患者(30.1%)发生脑血管痉挛.Hunt-Hess分级≥Ⅲ级血管痉挛发生率明显高于Hunt-Hess分级Ⅰ-Ⅱ级,差异有统计学意义(P<0.01);Fisher分级≥Ⅲ级血管痉挛发生率明显高于Fisher分级Ⅰ-Ⅱ级,差异有统计学意义(P<0.01);白细胞计数> 15×109的患者脑血管痉挛发生率(41.9%,18/43)明显升高(P<0.05).结论 Hunt-Hess分级≥Ⅲ级、Fisher分级≥Ⅲ级、白细胞计数增高是蛛网膜下腔出血后脑血管痉挛的危险因素.  相似文献   

5.
目的分析影响颅内动脉瘤破裂后手术预后的相关因素。方法应用Logistic回归模型,对91例患者性别、年龄、高血压病史、病情HuntandHess分级、蛛网膜下腔出血Fisher分级等5项指标共14个水平分别进行单因素及多因素分析。结果年龄≥60岁、蛛网膜下腔出血Fisher分级和病情HuntandHess分级是影响动脉瘤手术预后的独立危险因素。结论通过年龄、蛛网膜下腔出血Fisher分级和病情HuntandHess分级可大致评估预后,要建立精确的预测模型,仍需加大样本量。  相似文献   

6.
目的探讨影响蛛网膜下腔出血动脉瘤开颅夹闭术后并慢性脑积水的独立危险因素。方法回顾性分析我院2010-01—2015-01收治的278例动脉瘤行开颅夹闭术患者的临床资料。结果单因素分析发现年龄、高血压史、高血压分级、出血破入脑室、动脉瘤的位置、SAH Fisher级别、SAH Hunt-Hess级别存在统计学差异。在进一步的多因素回归分析中,我们发现年龄、出血破入脑室、SAH Fisher级别、SAH Hunt-Hess级别是独立危险因素。结论临床上应该关注以上4个危险因素,根据患者的病情持续观察这种迟发型并发症,并通过手术方式及时给予干预,以减少慢性脑积水对患者产生的不良后果。  相似文献   

7.
目的 分析动脉瘤性蛛网膜下腔出血(aSAH)后无迟发性脑缺血(DCI)的相关因素,以期为DCI病人转出重症监护病房(ICU)提供临床依据.方法 选取2001-10 2011-06确诊的动脉瘤性蛛网膜下腔出血且入住重症监护病房患者153例,其中DCI组67例,非DCI组86例;分析蛛网膜下腔出血后无迟发性脑缺血的相关因素.结果 DCI组一般情况相比非DCI组显示:平均年龄、入院血糖>6.1 mmol/L、后循环动脉瘤、脑室出血差异有统计学意义(P<0.05);服用他汀类药物、GCS评分、WFNS Ⅰ~Ⅲ级、改良Fisher分级Ⅰ~Ⅱ级、TCD血管痉挛、血管造影血管痉挛差异有统计学意义(P<0.001);单因素分析显示:年龄>65岁,WFNS分级Ⅰ~Ⅲ级、改良Fisher分级1~2级、无颅内血肿和后交通动脉瘤与动脉瘤性蛛网膜下腔出血后无迟发性脑缺血相关(P<0.05);多因素分析发现年龄>65岁,WFNS Ⅰ~Ⅲ级,改良Fisher分级1~2级是未发生DCI的独立因素.结论 年龄>65岁,WFNSⅠ~Ⅲ级和改良Fisher分级1~2级可作为病人转出ICU病房的依据.  相似文献   

8.
目的 探讨蛛网膜下腔出血(SAH)患者并发下肢深静脉血栓(LDVT)的危险因素和预防策略.方法 对98例蛛网膜下腔出血患者进行双下肢血管超声检查,根据是否发生LDVT分为LDVT组和对照组,对患者长期卧床、血浆纤维蛋白原、股静脉穿刺、静脉曲张、高血压、性别、吸烟、饮酒、糖尿病、肥胖、Hunt和Hess分级等相关因素与LDVT的相关性进行分析.结果 98例蛛网膜下腔出血患者中LDVT组1 8例(18.37%),对照组80例(81.63%).高龄、长期卧床、股静脉穿刺、高血压、高血浆纤维蛋白原、Hunt和Hess分级高为LDVT较显著的危险因素(P<0.05);而静脉曲张、饮酒、吸烟、糖尿病、肥胖、性别等因素与LDVT无显著相关性.结论 蛛网膜下腔出血合并LDVT患者多见于年龄偏大、合并高血压等、Hunt和Hess分级较高,血浆纤维蛋白原水平较高、股静脉穿刺者.  相似文献   

9.
目的分析动脉瘤性蛛网膜下腔出血后脑血管痉挛的危险因素。方法选择郑州市第一人民医院2012-01—2018-03住院治疗的301例动脉瘤性蛛网膜下腔出血者为研究对象。分析患者入院时的基本资料、动脉瘤大小和数量、Hunt-Hess分级、改良Fisher分级、动脉瘤治疗方法、实验室检查结果与血管造影血管痉挛(AV)、有症状的血管痉挛(SV)、脑梗死的相关性,并分析SV、AV、脑梗死独立危险因素。结果入院时年龄≥53岁、改良Fisher分级3~4级、Hunt-Hess分级4~5级、白细胞计数水平≥11×10~9个/L、血糖水平≥7.0 mmol/L是AV、SV、脑梗死的危险因素(P0.05)。此外,高血压史和吸烟是SV或脑梗死的危险因素;动脉瘤直径≥1 cm是AV或SV的危险因素(P0.05)。多因素分析显示,入院时改良Fisher分级3~4级、Hunt-Hess分级4~5级、白细胞计数水平≥11×10~9个/L、高血压史是SV、AV、脑梗死的独立危险因素(P0.05)。此外,血糖水平≥7.0 mmol/L也是AV的独立危险因素(P0.05);动脉瘤直径≥1 cm也是SV的独立危险因素(P0.05);年龄≥53岁、吸烟史也是脑梗死的独立危险因素(P0.05)。结论动脉瘤性蛛网膜下腔出血后脑血管痉挛不同类型危险因素存在差异。  相似文献   

10.
目的 分析蛛网膜下腔出血(subarachnoid hemorrhage,SAH)患者并发下肢深静脉血栓(deep venous thrombosis,DVT)的危险因素,为DVT的预防和治疗提供临床指导。 方法 连续收集2017年5-12月于首都医科大学附属北京天坛医院神经内科收治的SAH患者的临床 资料,根据患者住院期间是否发生DVT分为DVT组和无DVT组,收集患者年龄、性别、用药史、实验室 检查、卒中危险因素及Hunt-Hess分级和世界神经外科联盟评分等资料,采用单因素及多因素logistic回 归分析SAH后下肢DVT的危险因素。 结果 共纳入328例SAH患者,其中26例(7.9%)住院期间出现DVT。多因素分析结果显示,年龄增 长(OR 1.051,95%CI 1.012~1.091,P =0.0097)和血小板计数升高(OR 1.008,95%CI 1.000~1.015, P =0.0493)是SAH患者住院期间发生DVT的独立危险因素。 结论 年龄增长和血小板计数升高是SAH患者住院期间发生DVT的独立危险因素。  相似文献   

11.
目的分析伴智能障碍的脑白质疏松症(LA)患者的相关危险因素。方法 207例LA患者分为伴有智能障碍组和无智能障碍组,对患者的性别、年龄、高血压病史、糖尿病史、冠心病史及既往脑梗死病史等进行相关因素分析和Logistic回归分析。结果两组年龄、高血压病史、糖尿病史、既往脑梗死病史和LA的严重程度均有显著差异。多因素回归分析最终入选模型的变量是年龄、高血压病史、既往脑梗死病史和重度LA。结论高龄、高血压病史、既往脑梗死病史和重度LA,对LA是否伴智能障碍有独立的提示作用。  相似文献   

12.
目的 探讨内蒙古通辽市脑出血与冠心病患者危险因素的分布.方法 随机抽取该地区3级和2级综合医院各3家病案室中2003~2005年诊断为脑出血、冠心病的患者病历资料共3867份,对其发病的相关危险因素进行调查和分析.结果 内蒙古通辽市人群脑出血和冠心病的基线资料中所调查危险因素都有统计学意义;单因素回归分析发现,性别、年龄、民族、吸烟、饮酒、高血压、三酰甘油、血糖等10个因素均有统计学意义.对这10个变量进行多因素Logistic逐步回归分析,性别、年龄、吸烟、既往高血压史、既往糖尿病史、三酰甘油、血糖、高血压8个变量进入模型.结论 与冠心病相比,年龄、吸烟、既往糖尿病史、三酰甘油对脑出血影响相对较小,而性别、既往高血压史、血糖、高血压对脑出血影响相对较大.  相似文献   

13.
进展性卒中相关因素临床分析   总被引:5,自引:1,他引:4  
目的 探讨影响进展性卒中的相关危险因素.方法 选取2009-11~2010-10潍坊市中医院中风科住院的72 h内新发脑梗塞患者87例,分为进展性卒中组与非进展性卒中组,观察项目包括:年龄、性别等一般资料的比较,神经功能评分,日常生活能力评分,既往史评分,伴发疾病评分,预后评分及卫生经济学等,对各因素进行单因素分析,然...  相似文献   

14.
青中年缺血性脑卒中危险因素的病例对照研究   总被引:13,自引:0,他引:13  
目的 调查青中年缺血性脑卒中的危险因素,指导该地区的高危人群的干预治疗。方法 对2001年入院、年龄分布在18-59岁之间,经影像学证实的162例缺血性脑卒中患者进行1:1的病例对照研究。结果 单因素分析结果显示:高血压、性格急躁、头痛头晕病史、家族史、高胆固醇及睡眠失调是青中年缺血性脑卒中的主要危险因素。结论 多因素分析结果证实:高血压、性格急躁、头痛头晕病史、高胆固醇为主要危险因素。  相似文献   

15.
Hypertension as a risk factor for spontaneous intracerebral hemorrhage   总被引:10,自引:0,他引:10  
To better define the etiologic importance of hypertension for spontaneous intracerebral hemorrhage, hospital records were studied for all patients sustaining intracerebral hemorrhage during 1982 in the Cincinnati metropolitan area. Hypertension pre-dating the hemorrhage was present in 45% (69 of 154), as determined by history. A more inclusive definition of hypertension, combining those with a positive history with those found to have left ventricular hypertrophy by electrocardiogram or cardiomegaly by chest radiography, applied in 56% (87 of 154). The cases were compared to controls with and without hypertension derived from the NHANES II study of blood pressure (n = 16,204) to determine relative risk. For the presence of hypertension by history, the relative risk of intracerebral hemorrhage was 3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was also determined for hypertension in blacks (= 4.4), age greater than 70 (= 7), prior cerebral infarction (= 22), and diabetes (= 3). We conclude that the term "hypertensive hemorrhage" should be used very selectively, particularly in whites, and propose that hypertension be viewed as one of several important risk factors for spontaneous intracerebral hemorrhage.  相似文献   

16.
目的探讨缺血性脑卒中(cerebral ischemic stroke,IS)患者合并脑微出血(cerebral microbleeds,CMBs)的危险因素。方法回顾性收集2015年1月至2017年5月作者医院神经内科连续收治的IS住院患者1631例,根据是否存在CMBs分为合并CMBs组703例和未合并CMBs组928例。分析两组间性别构成、年龄、血压、体重、体重指数(body mass index,BMI)、血糖、尿酸、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-c)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-c)、载脂蛋白A(apolipoproteins A,apoA)、载脂蛋白B(apolipoproteins B,apoB)、吸烟史、饮酒史、高血脂史、糖尿病史、高血压史、心脏疾病史、脑白质高信号(white matter hyperintensity,WMH)的差异,并采用多因素Logistic回归分析影响IS患者发生CMBs的危险因素。结果与未合并CMBs组比较,合并CMBs组患者年龄大,男性、吸烟、饮酒、高血压、糖尿病、WMH构成比例高,空腹血糖、尿酸水平高(均P<0.05),而空腹LDL-c和apoA水平较低(均P<0.05)。多因素Logistic回归分析显示吸烟(OR=5.791,95%CI:3.714~9.031,P<0.01)、饮酒(OR=7.306,95%CI:4.926~10.835,P<0.01)、高血压(OR=2.162,95%CI:1.487~3.143,P<0.01)、WMH(OR=3.249,95%CI:1.594~6.625,P<0.01)、LDL-c(OR=0.789,95%CI:0.630~0.989,P<0.05)、apoA(OR=0.696,95%CI:0.369~0.753,P<0.01)是IS合并CMBs的独立危险因素。结论吸烟、饮酒、高血压、WMH、LDL-c、apoA是IS合并CMBs的独立危险因素,且LDL-c和apoA水平下降与CMBs发生增加相关。  相似文献   

17.
BACKGROUND: Intracerebral hemorrhage(ICH) and coronary heart disease (CHD) have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE: To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN: Retrospective analysis. SETTING: School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS: Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS: The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire "Stroke and Coronary Heart Disease Epidemiologic Questionnaire". The main contents included: ①Social demography condition: The distributions of gender, age, nationality, etc. ②Previous history of disease: hypertension, diabetes mellitus, etc. ③Related risk factors: systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose (GLU). The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES: Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS: Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride (TG), and GLU ten factors(OR =0.199, OR 95% CI 0.142–0.280 to OR =7.484, OR 95% CI 6.186–9.054, P < 0.01). ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG(OR =0.203, OR 95% CI 0.114–0.361 to OR =8.262,OR 95% CI 5.466–12.491, P < 0.01). CONCLUSION: ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.  相似文献   

18.
目的:探讨无抽搐电休克治疗(MECT)导致滞留在麻醉后监护室(PACU)时间延长的危险因素。方法:选取我院自2018年1月至2020年1月收治的200例接受MECT的患者,按照是否滞留在PACU时间延长分为观察组(36例)与对照组(164例)。统计两组的临床资料,采用Logistic回归分析法筛选PACU滞留时间延长的危险因素。结果:两组年龄、体质量指数(BMI)、疾病分类、1周内MECT治疗次数、阻塞型睡眠呼吸暂停综合征(OSAHS)病史、合并高血压比较差异具有统计学意义(P<0.05或P<0.01)。单因素分析显示,年龄越大、BMI越大、疾病类型为精神分裂症、1周内MECT治疗次数越多、有OSAHS病史、合并高血压,MECT后发生滞留PACU时间延长的风险性越高(P<0.05或P<0.01)。Logistic回归分析法显示,年龄、精神分裂症、1周内MECT治疗次数越多、OSAHS病史、合并高血压是MECT后滞留PACU时间延长的独立危险因素(P<0.05或P<0.01)。结论:年龄大、精神分裂症、1周内MECT治疗次数越多、有OSAHS病史、合并高血压会增加MECT后滞留在PACU时间延长的风险。  相似文献   

19.
The objective of this study is to investigate the risk factors of stroke in a community in Chongqing by setting quantitative criteria for determining the risk factors of stroke. Thus, high-risk individuals can be identified and laid a foundation for predicting individual risk of stroke. 1,034 cases with 1:2 matched controls (2,068) were chosen from five communities in Chongqing including Shapingba, Xiaolongkan, Tianxingqiao, Yubei Road and Ciqikou. Participants were interviewed with a uniform questionnaire. The risk factors of stroke and the odds ratios of risk factors were analyzed with a logistic regression model, and risk exposure factors of different levels were converted into risk scores using statistical models. For men, ten risk factors including hypertension (5.728), family history of stroke (4.599), and coronary heart disease (5.404), among others, were entered into the main effect model. For women, 11 risk factors included hypertension (5.270), family history of stroke (4.866), hyperlipidemia (4.346), among others. The related risk scores were added to obtain a combined risk score to predict the individual’s risk of stoke in the future. An individual health risk appraisal model of stroke, which was applicable to individuals of different gender, age, health behavior, disease and family history, was established. In conclusion, personal diseases including hypertension, diabetes mellitus, etc., were very important to the prevalence of stoke. The prevalence of stroke can be effectively reduced by changing unhealthy lifestyles and curing the positive individual disease. The study lays a foundation for health education to persuade people to change their unhealthy lifestyles or behaviors, and could be used in community health services.  相似文献   

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