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目的探讨进展性缺血性脑卒中的危险因素及其预测价值。方法将本院在2013年10月~2014年10月期间收治的226例脑卒中患者按病情是否进展分为实验组(58例)与对照组(168例);应用实验室和影像学检测D-二聚体、空腹血糖、颈动脉斑块等相关指标。结果 2组颈动脉斑块(χ~2=20.345,P<0.001)具有明显差异;且2组的入院时收缩压(t=6.389,P<0.001)和SSS评分(t=11.800,P<0.001)也均具有明显的差异,入院后血压降低(χ~2=43.560,P<0.001)也有明显差异。2组的D-二聚体(t=14.698,P<0.001)、空腹血糖(t=7.043,P<0.001)、同型半胱氨酸(t=25.902,P<0.001)等因素的差异均具有统计学意义。作多因素Logistic回归分析表明,D-二聚体(χ~2=22.918,P<0.001)、空腹血糖(χ~2=32.062,P<0.001)、颈动脉斑块(χ~2=16.792,P<0.001)、入院后血压下降(χ~2=38.270,P<0.001)、糖尿病史(χ~2=4.798,P=0.0285)均有统计学意义(P<0.05)。结论有糖尿病史的缺血性脑卒中患者若入院后其血压显著降低,且应用实验室检测静脉血中D-二聚体以及空腹血糖含量增加,或应用影像学检查颈动脉斑块时极大可能会恶化或使病情进行性加重;即这五个因素就是进展性缺血性脑卒中的危险因素。
Objective To explore the risk factors of progressive ischemic stroke and its predictive value. Methods Totally 226 stroke patients treated in our hospital from October 2013 to October 2014 were divided into experimental group (58 cases) and control group (168 cases) according to whether the disease was progressing or not. The laboratory and imaging examination of D - dimer, fasting blood glucose, carotid plaque and other related indicators. Results The systolic blood pressure (t = 6.389, P <0.001) and SSS score (t = 11.800, P <0.001) were significantly different between the two groups (χ ~ 2 = 20.345, ) Also had significant differences. There was also a significant difference in blood pressure after admission (χ ~ 2 = 43.560, P <0.001). D-dimer (t = 14.698, P <0.001), fasting blood glucose (t = 7.043, P <0.001) and homocysteine (t = 25.902, Statistical significance. Multivariate logistic regression analysis showed that there was no significant difference in fasting blood glucose (χ ~ 2 = 32.062, P <0.001), carotid plaques (χ ~ 2 = 16.792, (P <0.001). After admission, the blood pressure decreased (χ ~ 2 = 38.270, P <0.001), and the history of diabetes (χ ~ 2 = 4.798, P = 0.0285) had statistical significance (P <0.05). CONCLUSIONS: In patients with ischemic stroke who have a history of diabetes, if their blood pressure is significantly lower after admission, laboratory D-dimer levels in venous blood and fasting blood glucose levels should be increased, or when carotid plaques are examined by imaging May worsen or exacerbate the condition; these five factors are risk factors for progressive ischemic stroke.