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目的探讨后循环脑梗死的危险因素及预后影响因素。方法回顾性分析2011年3月—2013年12月在唐山市工人医院神经内科收治的急性脑梗死患者,用Excel表格收集急性脑梗死的发病危险因素及可能影响预后的相关因素,包括年龄、性别、高血压、高血脂、糖代谢异常等资料。统计循环脑梗死和后循环脑梗死患者的例数,采用统计学软件分析后循环脑梗死的危险因素。病后3个月复查时,采用改良Rankin量表(mRS)对患者预后进行评估,mRS评分≤2分为预后良好,mRS>2分为预后不良。统计预后良好组和预后不良组的例数,采用统计学软件分析后循环脑梗死的预后影响因素。结果 Logistic回归分析结果显示,与发生后循环梗死相关的危险因素有3项:高同型半胱氨酸血症、房颤、既往TIA史。3个月复查时,预后良好56例(65.1%),预后不良30例(34.9%)。经过Logistic回归分析,与后循环脑梗死静脉溶栓后患者近期预后不良相关的因素有4项:入院时NIHSS评分>12、发病至溶栓时间>4.5 h、高同型半胱氨酸血症、24h后抗血小板。结论对于后循环梗死患者,尽早溶栓且溶栓后及时进行抗凝治疗对改善近期预后有一定意义。
Objective To investigate the risk factors and prognostic factors of posterior circulation cerebral infarction. Methods A retrospective analysis was conducted on the risk factors of acute cerebral infarction and related factors that may affect the prognosis of patients with acute cerebral infarction admitted to Department of Neurology, Tangshan Workers Hospital from March 2011 to December 2013, including age, gender , Hypertension, hyperlipemia, abnormal glucose metabolism and other information. Statistical analysis of circulating cerebral infarction and posterior circulation patients with cerebral infarction, the use of statistical software analysis of risk factors for recurrent cerebral infarction. Patients were evaluated for prognosis using a modified Rankin Scale (mRS) at 3 months after disease review. The mRS score of ≤2 was classified as good prognosis and mRS> 2 as poor prognosis. Statistical good prognosis and poor prognosis group cases, the use of statistical software to analyze the prognostic factors of posterior circulation cerebral infarction. Results Logistic regression analysis showed that there were 3 risk factors associated with post-infarction infarction: hyperhomocysteinemia, atrial fibrillation and previous TIA history. At 3 months of follow-up, the prognosis was good in 56 (65.1%) and poor prognosis in 30 (34.9%). After Logistic regression analysis, there were 4 factors related to the short-term prognosis of patients with posterior circulation cerebral infarction after thrombolysis: NIHSS score> 12 on admission, onset to thrombolysis time> 4.5 h, hyperhomocysteinemia, Anti-platelet after 24h. Conclusion For patients with posterior circulation infarction, as soon as thrombolysis and timely anticoagulant therapy after thrombolysis to improve the short-term prognosis of a certain significance.