进展性脑梗死相关因素分析

目的 探讨进展性脑梗死的相关因素,为临床早期诊断和治疗提供依据.方法 将起病在24 h内852例首次发病的脑梗死患者分成两组.比较有进展与无进展的脑梗死患者的特征、危险因素、重要体征、头部CT、彩超下颈动脉粥样硬化特征以及预后情况.进展性脑梗死的诊断根据起病到7 d内肌力下降情况或神经功能缺损评分来判断.结果 852例患者中有206例发展为进展性脑卒中(24.18%),有进展的患者头颅CT早期异常(78.24%)及严重颈动脉狭窄的患者较无进展的患者多;血流动力学指标异常率高;有进展的患者入院时血糖较无进展的高;医源性处理不当亦为进展性脑梗死形成的重要危险因素.有进展的脑梗死患者急性期病死率高,神经功能恢复差.结论 进展性脑梗死的发生与很多因素有关(如头颅CT早期异常、颈动脉粥样硬化的严重程度、狭窄程度、入院时高血糖及血流动力学指标变化),医源性处理不当,均可能是进展性脑梗死发生的重要因素.

Study on related factors of deteriorating cerebral infarction

Objective To investigate the possible cause of the deteriorating stroke in various types patients with cerebral infarction in order to provide important objective basis for clinical diagnosis and treatment. Methods 852 patients with the first cerebral infarction hospitalized within 24hr after the onset of disease were divided into the 2 groups. The deteriorating stroke was diagnosed according to a decrease of muscular strength and neurological function deficits scale during 7days after the onset. In each gr...