进展性缺血性脑卒中危险因素分析及微栓子对卒中进展的预测价值

目的 探讨进展性缺血性脑卒中（PIS）患者的危险因素及微栓子对进展性卒中的预测价值。方法 纳入2016年3月至2018年3月就诊于内蒙古自治区人民医院神经内科的50例PIS患者及同时期非进展的缺血性卒中病人62例，所有纳入的患者均行头颅磁共振、颈动脉血管超声、心脏彩超、心电图、48 h内微栓子检查，并对纳入的患者进行问卷调查。结果 微栓子阳性PIS患者病灶多位于皮质（P<0.05）。PIS与微栓子、低密度脂蛋白异常、院前未服用阿司匹林、院前服用降压药物、颈动脉斑块等因素显著相关（P<0.05）。logistic回归分析提示微栓子（OR=7.246，P=0.001）、低密度脂蛋白异常（OR=3.879，P=0.007）、颈动脉斑块（OR=4.177，P=0.007）、院前未口服阿司匹林（OR=4.304，P=0.046）、院前服用降压药物（OR=3.734，P=0.01）为PIS的独立危险因素。结论 微栓子、低密度脂蛋白异常、院前未口服阿司匹林、院前服用降压药物、颈动脉斑块是PIS危险因素，且微栓子更具预测价值。

Risk factors for progressive ischemic stroke and the value of microemboli in predicting stroke progression

Objective To investigate the risk factors for progressive ischemic stroke (PIS) and the value of microemboli in predicting progressive stroke.Methods A total of 50 patients with PIS and 62 patients with non-progressive ischemic stroke (NPIS) who were admitted to Department of Neurology, Inner Mongolia People's Hospital, from March 2016 to March 2018 were enrolled. All patients underwent cranial magnetic resonance imaging, carotid artery ultrasound, echocardiography, electrocardiography, and microembolic signal monitoring within 48 hours, and a questionnaire survey was performed for all patients.Results Most of the lesions in PIS patients with microemboli were located in the cortex (P<0.05). PIS was significantly associated with microemboli, abnormal low-density lipoprotein, no administration of aspirin before admission, administration of antihypertensive drugs before admission, and carotid plaque (P<0.05). The logistic regression analysis showed that microemboli (odds ratio[OR]=7.246, P=0.001), abnormal low-density lipoprotein (OR=3.879, P=0.007), carotid plaque (OR=4.177, P=0.007), no administration of aspirin before admission (OR=4.304, P=0.046), and administration of antihypertensive drugs before admission (OR=3.734, P=0.01) were independent risk factors for PIS.Conclusions Microemboli, abnormal low-density lipoprotein, no administration of aspirin before admission, administration of antihypertensive drugs before admission, and carotid plaque are the risk factors for PIS, and microemboli have a certain predictive value.