进展性脑梗死的危险因素分析

目的探讨进展性脑梗死的危险因素。方法回顾性分析2009年6月至2012年12月山西省长治市人民医院的200例急性脑梗死患者的临床资料，按疾病类型分为观察组100例（进展性脑梗死）和对照组100例（完全性脑梗死）。观察2组患者的年龄、糖尿病史、高血压病史、冠心病史、吸烟史、饮酒史、平均动脉压、血糖、白细胞计数、颈动脉狭窄、颅内动脉狭窄等因素以及影像学特征。结果观察组和对照组患者的糖尿病史、平均动脉压、白细胞计数、血糖、低密度脂蛋白胆固醇、颈动脉狭窄、颅内动脉狭窄比较，差异均有统计学意义［58例（58.0%）比43例（43.0%），（115±13）mmHg（1 mmHg=0.133 kPa）比（130±15）mmHg，（8.1±0.8）×109/L比（6.6±0.4）×109/L，（7.5±0.5）mmol/L比（5.6±0.4）mmol/L，（2.2±0.2）mmol/L比（1.5±0.2）mmol/L，48例（48.0%）比34例（34.0%），39例（39.0%）比25例（25.0%）］（均P＜0.05）。观察组头颅CT早期低密度改变、大脑中动脉高密度征、完全性前循环梗死、分水岭梗死的发生率与对照组比较，差异均有统计学意义［33.0%（33例）比20.0%（20例），13.0%（13例）比6.0%（6例），39.0%（39例）比26.0%（26例），53.0%（53例）比39.0%（39例）］（均P＜0.05）。结论平均动脉压、血糖、血脂、颅内外动脉狭窄、发热为进展性脑梗死的危险因素；头颅CT早期低密度影、大脑中动脉高密度征、完全性前循环梗死、分水岭梗死对进展性脑梗死发生有早期预警意义。

Analysis of risk factors of progressive ischemic cerebral infarction

ObjectiveTo investigate the risk factors of progressive ischemic cerebral stroke. MethodsThe clinical data of 200 patients suffering from acute cerebral infarction were retrospectively analyzed and divided into experimental group [100 cases （progressive cerebral infarction） ]and control group [100 cases （non progressive cerebral infarction）] according to the disease type. Age, history of hypertension, diabetes mellitus, coronary heart disease, smoking and alcohol drinking, mean arterial pressure, serum glucose, white blood cell count, serum lipoprotein level, stenosis of carotid and intracranial arteries, characteristics of imaging in two groups were observed. Results Type 2 diabetes mellitus, mean arterial pressure, white blood cell count, serum glucose, serum lipoprotein level, stenosis of carotid and intracranial arteries were more significant in experimental group than those in control group [58 cases （58.0%） vs 43 cases （43.0%）, （115±13）mmHg vs （130±15）mmHg, （8.1±0.8）×109/L vs （6.6±0.4）×109/L, （7.5±0.5）mmol/L vs （5.6±0.4）mmol/L, （2.2±0.2）mmol/L vs （1.5±0.2）mmol/L, 48 cases （48.0%） vs 34 cases （34.0%）, 39 cases （39.0%） vs 25 cases （25.0%）] （P〈0.05）. There were significant differences of the incidence rate of early low density shadow, total anterior circulation infarct, watershed infarction of skull CT in observation group compared with control group [33.0%（33 cases） vs 20.0%（20 cases）,13.0%（13 cases） vs 6.0%（6 cases）,39.0%（39 cases） vs 26.0%（26 cases）,53.0%（53 cases） vs 39.0%（39 cases）] （P〈0.05）. ConclusionPCI is related to mean arterial pressure, serum glucose, serum lipoprotein level, stenosis of carotid and intracranial arteries, fever, early low density lesion on cerebral CT, high density of middle cerebral artery, total anterior circulation infarction and watershed infarction.