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      标题:合并大脑中动脉狭窄的急性缺血性卒中患者一年期预后的影响因素分析
      作者:高爱民,刘永刚,任翠剑,许云鹤,王宁,齐伟静    (保定市第一中心医院神经内一科,河北 保定 071000)
      卷次: 2018年29卷1期
      【摘要】 目的 分析影响合并大脑中动脉狭窄的急性缺血性卒中患者一年期预后的危险因素。方法 收集2014年2月至2016年2月期间保定市第一中心医院神经内一科收治的120例合并大脑中动脉狭窄的急性缺血性卒中患者的人口学资料、疾病史、大脑中动脉狭窄程度及神经缺损程度等资料,检测入院时炎性因子白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、可溶性细胞黏附分子-1 (sICAM-1)、基质金属蛋白酶 9 (MMP-9)、超敏C反应蛋白(CRP)水平,根据1年随访结果将患者分为预后良好组和预后不良组。结果 120例患者中预后良好78例,预后不良 42例。与预后良好组相比,预后不良组患者的年龄、高脂血症和卒中史比例、美国国立卫生研究院卒中量表(NIHSS)评分明显较高,差异均有统计学意义(P<0.05);两组患者的大脑中动脉狭窄程度分布、各项炎性因子(IL-6、TNF-α、CRP、sICAM-1、MMP-9)水平比较差异均有显著统计学意义(P<0.01)。多因素回归分析结果显示,炎性因子水平、NIHSS评分、卒中史、大脑中动脉狭窄程度、年龄是合并大脑中动脉狭窄的急性缺血性卒中患者预后不良的危险因素(P<0.05)。结论 外周血炎性因子水平显著增高是大脑中动脉狭窄的急性缺血性卒中患者一年期预后不良的危险因素,建议联合检测以制定针对性治疗方案。
      【关键词】 大脑中动脉狭窄;急性缺血性卒中;炎性因子;预后
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350(2018)01—0037—04
Influence factors of one-year prognosis in patients with acute ischemic stroke complicated with cerebral middleartery stenosis. GAO Ai-min, LIU Yong-gang, REN Cui-jian, XU Yun-he, WANG Ning, QI Wei-jing. Department ofNeurology, Baoding First Central Hospital, Baoding 071000, Hebei, CHINA
      【Abstract】 Objective To analyze the influence factors of one-year prognosis in patients with acute ischemicstroke complicated with cerebral middle artery stenosis. Methods The demographic data, history of diseases, degreeof cerebral middle artery stenosis and nerve defect of 120 patients with acute ischemic stroke complicated with middlecerebral artery stenosis from February 2014 to February 2016 in the Department of Neurology, Baoding First CentralHospital were collected. Levels of inflammatory factors (interleukin-6 [IL-6], tumor necrosis factor α [TNF-α]), solu-ble inter-cellular adhesion molecule-1 (sICAM-1), matrix metalloproteinase 9 (MMP-9) and high sensitive C reactiveprotein (CRP) were detected on admission. According to the 1-year follow-up results, the patients were divided intothe good prognosis group and the poor prognosis group. Results Among the 120 cases, the prognosis was good in 78cases and poor in 42 cases. Compared with the good prognosis group, the age, the incidence of hyperlipidemia andstroke and the National Institutes of Health Stroke Scale (NIHSS) score were significantly higher in the poor progno-sis group (P<0.05). The degree of cerebral middle artery stenosis and levels of inflammatory factors (IL-6, TNF-α,CRP, sICAM-1, MMP-9) showed statistically significant differences between the two groups (P<0.01). Multivariateregression analysis showed that levels of inflammatory factors (IL-6, TNF-α, CRP, sICAM-1, MMP-9), NIHSSscore, history of stroke, degree of cerebral middle artery stenosis and age were the risk factors for poor prognosis ofpatients with acute ischemic stroke complicated with cerebral middle artery stenosis (P<0.05). Conclusion Signifi-cant increase of peripheral blood inflammatory factors is the risk factor for poor 1-year prognosis of patients withacute ischemic stroke complicated with cerebral middle artery stenosis. Combined detection is recommended to devel-op targeted therapies.
      【Key words】 Cerebral middle cerebral artery stenosis; Acute ischemic stroke; Inflammatory factor; Prognosis·论 著·doi:10.3969/j.issn.1003-6350.2018.01.011

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