脑卒中近期预后相关因素分析

目的探讨脑卒中30天内死亡的相关因素，为脑卒中二级防治提供科学的理论支持。方法以212例首发脑卒中患者为研究对象，采集人口学因素、高血压史、症状体征、实验室指标、CT和MRI表现等临床资料，X2检验和生存分析统计学处理。结果寿命表法（LifeTable）计算30天累计生存率81．00％；X2分析显示脑卒中在性别、年龄、高血压史、收缩血压、白细胞（WBC）、空腹血糖（FPG）、血K＋、美国国立卫生院脑卒中量表评分（NIHSS）、Glasgow昏迷评分、卒中类型、卒中部位、病灶范围、脑结构移位各层组间有统计学意义（P〈0．05）；年龄≥70岁RR=2．706（95％CI1．167—6．274）]、出血性卒中RR=3．137（95％CI1．637—6．011）]、脑结构移位RR=2．933（95％cI1．531—5．620）]、大灶多发RR=3．288（95％CI1．195～9．051）]、NIHSS评分〉15分RR=2．214（95％CI1．156—4．241）]和FPG〉7．8mmol／LCRR：1．951（95％CI1．018～3．736）]的患者30天死亡的风险大。结论脑卒中30天内有较高的死亡率，年龄、卒中类型、脑结构移位、卒中范围、NIHSS和应激FPG是独立预后因素，对具有高危因素的患者临床应高度关注。

Analysis of Related Prognosis Factors on Stroke

Objective To study the relevant factors on the died stroke patients within 30 days for the secondary prevention of stroke and scientific arguments. Methods 212 cases of patients with first cerebral stroke,collection of demographic factors, history of hypertension, signs and symptoms, laboratory indicators,CT and MRI manifestations and other clinical data, chi-square test and survival analysis statistically were analyzed. Results Calculating the cumulative survival rate of 81.00% 30 days with life table method （Life Table）,Chi-square analysis showed that stroke in gender,age,history of hypertension, systolic blood pressure,white blood cell （WBC）, fasting plasma glucose （FPG）, blood K＋, U. S. National Institutes of Health Stroke Scale score（NIHSS）,Glasgow coma score, type of stroke, stroke location, lesion area, shift- ing layers of brain structure between groups was statistically significant（P〈0.05）. Aged≥70 yearsRR= 2. 706（95% CI 1. 167--6. 274）] ,hemorrhagic strokeRR=3. 137（95% CI 1. 637--6. 011）] ,brain structure shiftRR = 2. 933 （95 %CI 1. 531 -- 5. 620）], stove-prone RR = 3. 288 .（95% CI 1. 195 -- 9.051 ） ], NIHSS score〉of 15 minutesRR=2. 214（95% CI 1. 156--4. 241）land FPG〉7.8mmol/LRR= 1. 951 （95% CI 1.018--3. 736）]in patients with high risk of death 30 days. Conclusion Stroke has a higher mortality rate within 30 days. Age,type of stroke, brain structure shift, the scope of stroke, NIHSS and stress FPG are independent prognostic factors. Attention should be paid to the patients with clinical risk factors.