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目的探讨进展性缺血性脑卒中(PIS)的危险因素。方法选取唐山市工人医院2015年1月—2016年6月收治的PIS患者38例为进展组,另选取同期收治入院的非进展性缺血性脑梗死(NPIS)患者44例为非进展组。比较两组患者的性别、年龄、既往史(高血压、糖尿病)、体温、血压及低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、颈动脉狭窄程度,并采用多因素logistic回归分析PIS的危险因素。结果两组患者男性、高血压病史、LDL-C升高者所占比例及年龄比较,差异无统计学意义(P>0.05);进展组患者糖尿病病史、发热、Hcy升高、CRP升高、血压下降>30%、不稳定斑块、颈动脉中重度狭窄者所占比例高于非进展组(P<0.05)。多因素logistic回归分析结果显示,糖尿病病史[β=2.787,OR=16.232,95%CI(2.431,108.397)]、Hcy[β=3.991,OR=54.112,95%CI(5.855,500.064)]、CRP[β=2.513,OR=12.344,95%CI(1.898,80.266)]、血压[β=3.449,OR=31.476,95%CI(3.642,272.047)]、颈动脉狭窄程度[β=3.623,OR=37.453,95%CI(4.288,327.101)]是PIS的危险因素(P<0.05)。结论糖尿病病史、Hcy、CRP、血压、颈动脉狭窄程度是PIS的危险因素。
Objective To investigate the risk factors of progressive ischemic stroke (PIS). Methods Thirty-eight patients with PIS who were treated in Tangshan Workers Hospital from January 2015 to June 2016 were selected as the progression group. Forty-four non-progressive ischemic stroke patients (NPIS) were enrolled in this study. The differences of gender, age, past history (hypertension, diabetes), body temperature, blood pressure, low density lipoprotein cholesterol (LDL-C), homocysteine (Hcy), C-reactive protein Arterial stenosis and multivariate logistic regression analysis of risk factors for PIS. Results There was no significant difference in the proportions and ages of men with hypertension, history of hypertension and LDL-C in both groups (P> 0.05). Patients in the progression group had a history of diabetes mellitus, increased fever, increased Hcy and increased CRP, Blood pressure decreased> 30%, unstable plaques, carotid stenosis accounted for a higher proportion of non-progressing group (P <0.05). Multivariate logistic regression analysis showed that the incidence of diabetes mellitus was significantly higher in patients with diabetes mellitus (β = 2.787, OR = 16.232, 95% CI 2.431,108.397), Hcy [β = 3.991, OR = 54.112, 95% CI Blood pressure [β = 3.449, OR = 31.476,95% CI (3.642,272.047)], carotid stenosis [β = 3.623, OR = 12.344,95% CI 37.453,95% CI (4.288,327.101)] was a risk factor for PIS (P <0.05). Conclusion The history of diabetes mellitus, Hcy, CRP, blood pressure and carotid artery stenosis are risk factors of PIS.