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目的:探究进展性缺血性卒中预后的相关危险因素。方法:选取进展性缺血性卒中患者98例,根据复发情况将患者分为复发组和无复发组,分析进展性缺血性卒中复发与二级预防的关系。无复发组的患者按根据随访的mRS评分高低分为:预后良好组(mRS 0~2分)和预后差组(mRS 3~5分),分析影响预后的相关因素。结果:98例进展性缺血性卒中患者六个月复发率为10.2%(10/98)。无复发组较复发组应用降压药、降糖药、抗血小板聚集药物、他汀类降脂药的患者比例较复发组高,两组比较差异均具有统计学意义(P<0.05)。无复发组患者出院后一个月、三个月及六个月,单因素分析入院时白细胞计数、LDL、血糖与预后相关(P<0.05)。多因素logistic回归分析LDL、血糖和白细胞计数是影响出院后一个月预后的危险因素;血糖和白细胞计数是影响出院后三个月预后的危险因素;LDL和血糖是影响出院后六个月预后的危险因素。结论:良好的二级预防依从性有利于降低进展性缺血性卒中的复发率。入院时白细胞计数、LDL、血糖是影响进展性缺血性卒中预后的相关因素。入院时白细胞计数、LDL及空腹血糖值较高的进展性缺血卒中患者,其预后往往较差。
Objective: To explore the risk factors associated with the prognosis of progressive ischemic stroke. Methods: A total of 98 patients with progressive ischemic stroke were enrolled in this study. Patients were divided into recurrent group and non-recurrent group according to the recurrence status. The relationship between secondary ischemic stroke recurrence and secondary prevention was analyzed. The patients with no recurrence were divided according to follow-up mRS score: good prognosis group (mRS score 0 ~ 2) and poor prognosis group (mRS score 3 ~ 5), and to analyze the related factors influencing prognosis. Results: The six-month recurrence rate in 98 patients with progressive ischemic stroke was 10.2% (10/98). No recurrence group than the recurrence group using antihypertensive drugs, hypoglycemic agents, anti-platelet aggregation drugs, statins lipid-lowering drug than the recurrence group, the difference between the two groups were statistically significant (P <0.05). One month, three months and six months after discharge from hospital without recurrence group, univariate analysis showed that white blood cell count, LDL and blood glucose were associated with prognosis on admission (P <0.05). Multivariate logistic regression analysis showed that LDL, blood glucose and white blood cell count were the risk factors influencing the prognosis of one month after discharge. The blood glucose and white blood cell count were the risk factors affecting the prognosis of three months after discharge. LDL and blood glucose were the prognostic factors of six months after discharge Risk factors. CONCLUSIONS: Good secondary prevention compliance is helpful to reduce the recurrence rate of progressive ischemic stroke. Admission white blood cell count, LDL, blood glucose are the prognostic factors of progressive ischemic stroke. Patients with progressive ischemic stroke who have white blood cell counts, LDL, and fasting plasma glucose at admission have poor prognosis.