急性大脑半球梗死患者早期神经功能恶化的危险因素分析

目的探讨急性大脑半球梗死并发早期神经功能恶化的频率及其危险因素。方法采用斯堪的那维亚卒中量表(SSS)对98例急性大脑半球梗死患者的神经功能变化进行动态评估,并分析发病后24h的MRI特征。用两样本t检验或卡方检验比较2组患者入院时的基线资料,以Logistic逐步回归分析筛选神经功能进展的最终危险因素。结果98例急性大脑半球梗死患者中60(61.2%)例并发早期神经功能恶化,38(38.8%)例症状稳定;2组间18个单因素比较,年龄、既往糖尿病史、既往TIA或脑卒中史、体温、房颤、起病至入院时间、基线SSS评分、血胆固醇和CT上的早期低密度灶9项有差异(P0.05),Logistic回归分析筛选出的最终危险因素为基线SSS评分(OR:9.15;95%CI:2.47~15.19)、起病至入院时间(OR:6.82;95%CI:1.52~11.70)、入院时高体温(OR:5.86;95%CI:1.71~9.52)、CT上的早期低密度灶(OR:3.64;95%CI:1.25~6.61)和房颤(OR:1.79;95%CI:1.03~3.07);2组间MRI资料比较,脑组织肿胀、梗死容积均有差异(P0.001),且DWI梗死容积与基线SSS评分具有良好的相关性(P0.05)。结论急性大脑半球梗死患者早期神经功能恶化发生率高,主要的危险因素为基线SSS评分、起病至入院时间、入院时高体温、CT上的早期低密度灶和房颤。MRI检查有助于评估脑卒中的严重程度及进展。

Risk factors of early neurological deterioration after acute cerebral hemisphere infarction

Objective To explore the frequency and risk factors of early neurological deterioration after acute cerebral hemisphere infarction.Methods Neurological function was assessed dynamically in 98 acute cerebral hemisphere infarction patients by Scandinavian Stroke Scale,MRI features of the patients were also analyzed for 24 hours after onset of symptoms.Two-sample t test of chi-square test was used to compare the baseline data between two groups on admission and stepwise logistic regression was used to screen t...