论文部分内容阅读
目的探讨急性缺血性脑卒中部分危险因素聚集对患者发生复合结局的影响。方法连续性纳入2009年6月—2012年5月在辽宁省阜新市中心医院神经内科住院的所有急性缺血性脑卒中患者共3 151例,收集其人口学、体格检查、实验室检查、影像学检查结果等相关资料。患者出院时采用Modified Rankin’s scale(mRS)脑卒中量表进行评分,以0分≤mRS≤2分为对照组(2 640例),3分≤mRS≤5分为残疾组(407例),mRS=6分为死亡组(104例),3分≤mRS≤6分为残疾和死亡复合结局组(511例)。采用Cox回归分析急性缺血性脑卒中部分危险因素聚集对患者发生复合结局的影响。结果对照组、残疾组、死亡组急性缺血性脑卒中患者在年龄,体温、收缩压、舒张压、低密度脂蛋白胆固醇、肌酐、尿素氮、纤维蛋白原水平,卒中复发、血脂异常、肾功能异常、白细胞升高、清蛋白降低、高血糖、纤维蛋白原增高发生率方面差异均有统计学意义(P<0.05)。单因素和多因素Cox回归分析均显示,白细胞升高、清蛋白降低、高血糖及纤维蛋白原增高对急性缺血性脑卒中患者出院发生复合结局的影响有统计学意义(P<0.05)。单因素和多因素Cox回归分析结果显示,白细胞升高、清蛋白降低、高血糖及纤维蛋白原增高4项危险因素的个数为1个、2个、3个、4个时,对急性缺血性脑卒中患者出院发生复合结局的影响均有统计学意义(P<0.05);且随着危险因素聚集个数的增多,急性缺血性脑卒中患者出院发生复合结局的危险增大,有统计学意义(P<0.05)。结论随着白细胞升高、清蛋白降低、高血糖及纤维蛋白原增高危险因素聚集个数的增多,急性缺血性脑卒中患者出院发生复合结局的危险性就更大。
Objective To investigate the effect of some risk factors of acute ischemic stroke on the composite outcome of patients. Methods Continuity A total of 3 151 acute ischemic stroke patients hospitalized in Fuxin Central Hospital of Liaoning Province from June 2009 to May 2012 were enrolled in this study. Demographic, physical examination, laboratory tests, imaging School test results and other related information. The patients were discharged on the Modified Rankin’s scale (mRS) Stroke Scale score, 0 points ≤ mRS ≤ 2 points for the control group (2 640 cases), 3 points ≤ mRS ≤ 5 points for the disabled group (407 cases), mRS = 6 divided into death group (104 cases), 3 points ≤ mRS≤6 divided into complex disability and death outcome group (511 cases). Cox regression analysis of the impact of some risk factors of acute ischemic stroke in patients with composite outcome. Results Patients in control group, disability group and death group had significant differences in age, body temperature, systolic blood pressure, diastolic blood pressure, LDL cholesterol, creatinine, blood urea nitrogen, fibrinogen, stroke recurrence, dyslipidemia, Dysfunction, leukocytosis, decreased albumin, hyperglycemia, increased incidence of fibrinogen were statistically significant (P <0.05). Univariate and multivariate Cox regression analysis showed that leukocytosis, decreased albumin, hyperglycemia and increased fibrinogen had a significant effect on the composite outcome of patients with acute ischemic stroke discharged (P <0.05). Univariate and multivariate Cox regression analysis showed that the number of four risk factors of leucocyte increase, albumin decrease, hyperglycemia and fibrinogen increase were 1, 2, 3 and 4, There were significant differences in the composite outcome after discharge from patients with bloody stroke (P <0.05). With the increase of the number of risk factors, the risk of patients with acute ischemic stroke was higher Statistical significance (P <0.05). Conclusions With the increase of white blood cells, the decrease of albumin, the increase of the number of risk factors of hyperglycemia and fibrinogen accumulation, the greater the risk of complex outcome after discharge from acute ischemic stroke patients.