摘要
目的探讨脑梗死各风险指标对预后的预测价值。方法选取急性脑梗死患者99例,在发病72 h内检测血清超敏C反应蛋白(hs-cRP)、纤维蛋白原(Fg)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)和同型半胱氨酸(HCY)的含量,随访1年,将死亡及再发缺血性血管病变记录为影响预后的终点事件,按照各风险指标正常值将所有患者分为正常组和增高组,分别对两组患者进行生存分析比较;并对影响终点事件的各危险因素进行多元回归分析。结果hs-CRP增高组终点事件的发生率较正常组显著增加(18．18%和5．45%;P= 0．044;生存分析,log-rank检验);Fg、HCY增高组终点事件发生率高于正常组,但差别无显著性意义(P=0．399, P=0．898,生存分析,log-rank检验);而TG、TC、LDL-C增高组终点事件发生率低于正常组;hs-CRP增高与终点事件独立相关(OR 3．609,95%CI 0．869～14．992,P=0．047;Logistic分析)．结论hs-CRP增高可能是脑梗死发病1年内死亡和再发缺血性血管病变的独立危险因素,Fg和HCY增高可能影响预后但无显著意义,TG、TC、LDL-C增高可能与预后无明显关联,还需进行大样本研究加以证实。
Objective To evaluate the relationship between ischemic stroke risk factors and 1 year outcome.Methods Ninety-nine patients with acute ischemic stroke entered in this prospective observational study.High sensitivity C-reaction protein(hs-CRP),fibrinogen(Fg),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL -C)and homocysteine(HCY)were determined within 72 hours after ischemic stroke.The Kaplan-Meier technique was used in survival analysis and the Multiple logistic regression analysis was used to evaluate the associations between risk factors and out- come.Results Survival in those with CRP＞3 mg/L was significantly worse than in those with CRP≤3 mg/L(P=0.044, log-rank test).Survival in those with higher Fg and HCY were worse than those with normal levels.But the patients with higher TC,TG and LDL-C were found to have better survival than the normal.Higher hs-CRP concentration was an independent pre- dictor of death or new vascular event(OR,3.609,95% CI 0.869～14.992;P=0.032).Conclusion hs-CRP is more correlated with death or new vascular event than other risk factors.Higher Fg and HCY are correlated with death or new vascular event,but not significantly.There is no evidence found that TC,TG and LDL-C are the worse factors for 1 year outcome after ischemic stroke.
出处
《中国卒中杂志》
2006年第3期183-186,共4页
Chinese Journal of Stroke
