摘要
目的探讨非致残性缺血性脑血管事件患者早期进展(即神经功能缺损加重)的相关危险因素。方法回顾性连续纳入2016年1月至2019年12月在厦门大学附属第一医院神经内科住院的非致残性缺血性脑血管事件患者,根据发病7 d内美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分较发病时基线水平是否增加≥2分,分为进展组70例,非进展组254例,收集基线资料、临床及影像学特征并进行分析,采用多因素Logistc回归分析,寻找影响NICE患者早期进展的因素。结果单因素分析结果显示,进展组糖尿病、责任动脉狭窄或闭塞、急性感染、新发缺血性卒中比例较非进展组高,差异有统计学意义(P<0.05);比较两组间脑室旁白质高信号(periventricular white matter hyperintensity,PWMH)评分、深部脑白质高信号(deep white matter hyperintensities,DWMH)评分、PWMH+DWNH评分,进展组得较高分数(PWMH 2~3分、PWMH+DWNH 3~6分者)比例较非进展组高,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,糖尿病(OR=2.355,95%CI 1.220~4.546,P=0.011)、新发缺血性卒中(OR=2.820,95%CI 1.022~7.781,P=0.045)、急性感染(OR=4.513,95%CI 1.699~11.986,P=0.002)、责任动脉狭窄或闭塞(OR=2.542,95%CI 1.405~4.600,P=0.002)、较高的Fazekas评分[PWMH+DWMH 3~6分(OR=2.061,95%CI 1.119~3.798,P=0.020)、PWMH 2~3分(OR=2.046,95%CI 1.096~3.817,P=0.024)]是NICE患者早期进展的危险因素。结论糖尿病、新发缺血性卒中、急性感染、责任动脉狭窄或闭塞、较高的Fazekas评分(PWMH+DWMH 3~6分、PWMH 2~3分)等因素可能增加NICE患者早期进展的风险。
Objective To explore the risk factors for early deterioration in neurological function/progressive neurological deficit in patients with non-disabling ischemic cerebrovascular events(NICE).Methods We conducted a retrospective analysis consecutive patient with non-disabling ischemic cerebrovascular events from the Department of Neurology,the First Affiliated Hospital of Xiamen University between January 2016 and December 2019.Patients were divided into progressive group(n=70)and non-progressive group(n=254)and the term progressive were defined as patients had an increase in National Institutes of Health Stroke Scale(NIHSS)score by≥2 points within 7-day.Patient demographics,clinical and radiological data were recorded and analyzed.Multinomial logistic regression analysis was performed to determine the independent risk factors for early progression in patients with NICE.Results On univariate analysis,the incidence of diabetes mellitus,stenosis or occlusion in the corresponding artery,acute infection and new onset ischemic stroke were significantly higher in progressive group than in non-progressive group(P<0.05).The proportion of higher Fazekas scores(PWMH 2~3,PWMH+DWNH 3~6)in progressive group was significantly higher than that in non-progressive group(P<0.05).Multivariate logistic regression analysis showed that diabetes mellitus(OR=2.355,95%CI 1.220~4.546,P=0.011),stenosis or occlusion in the corresponding artery(OR=2.542,95%CI 1.405~4.600,P=0.002),acute infection(OR=4.513,95%CI 1.699~11.986,P=0.002),new onset ischemic stroke(OR=2.820,95%CI 1.022~7.781,P=0.045),higher Fazekas scores(PWMH+DWNH 3~6,OR=2.061,95%CI 1.119~3.798,P=0.020;PWMH 2~3,OR=2.046,95%CI 1.096~3.817,P=0.024)were independently associated with early progression in patient with NICE.Conclusion Diabetes mellitus,stenosis or occlusion in the corresponding artery,acute infection,new onset ischemic stroke,higher Fazekas scores(PWMH+DWNH 3~6,PWMH 2~3)may increase the risk of early progression in patient with NICE.
作者
万慧娟
蒋伟超
庄雄杰
WAN Huijuan;JIANG Weichao;ZHUANG Xiongjie(First-author’s Address:Department of Neurology,First Affiliated Hospital of Xiamen University,Xiamen 361003,China)
出处
《中风与神经疾病杂志》
CAS
2020年第5期429-434,共6页
Journal of Apoplexy and Nervous Diseases
关键词
非致残性缺血性脑血管事件
糖尿病
脑白质高信号
感染
Non-disabling ischemic cerebrovascular events
Diabetes mellitus
White matter hyperintensity
Infection
