Relative factors of early neurological deterioration in patients with acute ischemic stroke
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摘要: 目的 探讨急性缺血性脑卒中患者早期神经功能恶化(END)的危险因素。 方法 收集2017年8月—2019年2月南京鼓楼医院集团仪征医院神经内科收治的193例急性缺血性脑卒中患者的临床资料,根据早期END发生情况将患者分为END组(n=44)和非END组(n=149)。对2组患者的一般资料及临床指标进行单因素方差分析、多因素Logistic回归分析。 结果 2组患者入院时美国国立卫生研究院卒中量表(NIHSS)评分、入院时收缩压、C反应蛋白、C反应蛋白持续升高、胆固醇、低密度脂蛋白、同型半胱氨酸差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,入院时NIHSS评分、入院时收缩压、低密度脂蛋白、同型半胱氨酸、有无C反应蛋白持续升高是END的独立影响因素(P<0.05或P<0.01)。 结论 急性缺血性脑卒中患者发生END与入院时NIHSS评分、入院时收缩压、低密度脂蛋白、同型半胱氨酸、C反应蛋白持续升高关系密切。Abstract: Objective To explore the risk factors of early neurological deterioration(END)in patients with acute ischemic stroke. Methods From August 2017 to February 2019, the materials of 193 patients with acute ischemic stroke in the Department of Neurology of Yizheng Hospital of Nanjing Drum Tower Hospital Group were collected and divided into END group(n=44)and non-END group(n=149)according to the incidence of early neurological deterioration. The general materials and clinical indexes in both groups were analyzed by one-way ANOVA and multivariate Logistic regression analysis. Results There were significant differences in National Institutes of Health Stroke Scale(NIHSS)score at hospital admission, systolic blood pressure at hospital admission, C reactive protein, continuous rise of C reactive protein, cholesterol, low density lipoprotein and homocysteine between the two groups(P<0.05). Multivariate Logistic regression analysis showed that the NIHSS score at hospital admission, systolic blood pressure at hospital admission, low density lipoprotein, homocysteine and continuous rise of C reactive protein or not were the independent influencing factors of END(P<0.05 or P<0.01). Conclusion The incidence of END in patients with acute ischemic stroke is closely related to the NIHSS score at hospital admission, systolic blood pressure at hospital admission, low density lipoprotein, homocysteine and continuous rise of C reactive protein.
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