本文關(guān)鍵詞： 腦梗死 側(cè)支循環(huán) 危險(xiǎn)因素 早期神經(jīng)功能惡化　出處：《中國(guó)腦血管病雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的探討大腦中動(dòng)脈供血區(qū)急性腦梗死患者早期神經(jīng)功能惡化(END)的危險(xiǎn)因素。方法回顧性連續(xù)納入2009年1月至2012年12月于南京軍區(qū)南京總醫(yī)院神經(jīng)內(nèi)科住院的大腦中動(dòng)脈供血區(qū)急性腦梗死并完成全腦DSA檢查的患者81例。END定義為入院72 h內(nèi)美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分較入院基線評(píng)分增加≥2分或運(yùn)動(dòng)評(píng)分項(xiàng)增加≥1分。將所有患者根據(jù)是否發(fā)生END分為END組26例和非END組55例,采用單因素分析兩組間臨床資料的差異,側(cè)支循環(huán)分級(jí)標(biāo)準(zhǔn)采用美國(guó)介入治療神經(jīng)放射學(xué)學(xué)會(huì)/介入放射學(xué)學(xué)會(huì)側(cè)支循環(huán)評(píng)估系統(tǒng)。采用多因素Logistic回歸分析大腦中動(dòng)脈供血區(qū)急性腦梗死發(fā)生END的危險(xiǎn)因素。結(jié)果與非END組比較,END組患者年齡≥60歲[65.4%(17/26)比36.4%(20/55);χ~2=5.992,P=0.014]、超敏C反應(yīng)蛋白水平≥4.0 mg/L[76.9%(20/26)比45.5%(25/55);χ~2=7.080,P=0.008]及糖尿病患者比例[38.5%(10/26)比16.4%(9/55);χ~2=4.802,P=0.028]均顯著升高,而側(cè)支循環(huán)分級(jí)顯著降低(Z=-3.253,P0.01)。多因素Logistic回歸分析顯示,年齡≥60歲(OR=3.412,95%CI:1.075~10.824;P=0.037)、超敏C反應(yīng)蛋白水平≥4.0 mg/L(OR=3.812,95%CI:1.141~12.740;P=0.030)及側(cè)支循環(huán)分級(jí)(OR=2.165,95%CI:1.241~5.514;P=0.009)為大腦中動(dòng)脈供血區(qū)急性腦梗死發(fā)生END的獨(dú)立危險(xiǎn)因素。結(jié)論大腦側(cè)支循環(huán)分級(jí)下降和年齡≥60歲、超敏C反應(yīng)蛋白水平≥4.0 mg/L是大腦中動(dòng)脈供血區(qū)急性腦梗死發(fā)生END的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the early deterioration of neural function in patients with acute cerebral infarction in the middle cerebral artery (MCA) region. Methods from January 2009 to December 2012, acute cerebral infarction in the middle cerebral artery (MCA) supplying area was continuously included in the department of neurology, Nanjing general hospital of Nanjing military region, Nanjing military region from January 2009 to December 2012, and the whole brain DSA examination was completed. 81 cases examined. End defined as admission 72. The National Institutes of Health Stroke scale within h (NIH). All patients were divided into END group (n = 26) and non-#en2# group (n = 55) according to the occurrence of END. Univariate analysis was used to analyze the difference of clinical data between the two groups. The classification of collateral circulation was evaluated by the American Society of Interventional Radiology / Society of Interventional Radiology. Multivariate Logistic regression Analysis of Acute Cerebral Infarction in the Middle Cerebral artery. The risk factors of END were compared with those in non-#en1# group. Age 鈮，

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