椎-基底动脉系统脑梗死118例病情恶化危险因素分析

目的 探讨椎-基底动脉系统(VBS)脑梗死病情恶化的危险因素.方法 将符合入选标准的439例VBS梗死患者根据病情是否进展恶化分为两组:进展性卒中组(PS组)和非进展性卒中组(nPS组),采用单因素和多因素回归分析,分析进展性脑卒中的危险因素.结果 单因素分析显示,PS组与nPS组比较,在VBS狭窄积分、神经功能缺损评分(NIHSS)、血压分级、心房纤颤(AF)发生情况及空腹血糖(FBS)、纤维蛋白原 (Fib) 水平、溶栓和降纤治疗方面差别均有统计学意义(P＜0.05),而两组的低密度脂蛋白胆固醇(LDL-C)水平及抗凝和抗血小板治疗情况间差别均无统计学意义(P＞0.05).多因素回归分析显示VBS狭窄积分、NIHSS、高血压、高血糖、AF、溶栓或降纤治疗与病情进展恶化相关.结论 VBS狭窄积分、NIHSS、高血压、高血糖、AF是VBS脑梗死病情恶化的危险因素,溶栓或降纤治疗能够部分逆转脑梗死病情恶化的发生和发展过程.

Risk Factors of Early Neurological Deterioration of Cerebral Infarction in Vertebro-basilar System:Analyses of 118 Cases

Objectives To search for the risk factors of progressive stroke in 118 patients with infarction in vertebro-basilar system(VBS).Methods Four hundred and thirty-nine VBS infarction patients consistent with inclusion criteria were divided into groups progressive stroke(PS group) and nonprogressive stroke(nPS group).Single or multiple factor regression analysis was used to analyze the risk factors of progressive stroke.Results Single factor regressive analysis showed that there was significant difference between groups PS and nPS in VBS narrowing integration,NIHSS scores,BP grading,atrial fibrillation incidence,fasting blood glucose,fibrinogen level,and the treatment of thrombolysis and defibrase(P<0.05),but not in LDL-C level and treatments of anticoagulation and antiplatelet(P＞0.05).Multiple regression analysis showed that VBS narrowing,NIHSS scores,hypertension,hyperglycemia,auricular fibrillation,and thrombolysis and defibrase treatments were associated with the progressive deterioration of VBS infarction.Conclusions VBS arterioarctia,NIHSS scores,hypertension,hyperglycemia and auricular fibrillation are risk factors of deterioration of VBS infarction.Thrombolysis and defibrase treatments can partly reverse the incidence and development process of deterioration of cerebral infarction.