發(fā)布時間：2018-04-23 12:33

  本文選題：非瓣膜性房顫 + 腦梗塞體積　； 參考：《吉林大學》2017年碩士論文

【摘要】：目的回顧性分析非瓣膜性房顫(Non-valvularartial fibrillation,NVAF)并發(fā)急性腦梗塞患者的梗塞體積與左心房內徑、D-二聚體、平均血小板體積、動脈粥樣硬化危險因素、入院及出院時基礎狀況之間的關系,以期發(fā)現(xiàn)可能作為預測非瓣膜性房顫并發(fā)嚴重腦梗塞的相關指標。方法選取2014年9月1日～2016年9月1日于吉林大學第二醫(yī)院神經內科住院的急性腦梗塞患者,根據(jù)納入排除標準,選取其中合并非瓣膜性房顫者�；仡櫲虢M患者的病歷資料,收集其基本信息、既往疾病史、藥物服用史、入院時基礎狀況、入院后生化指標、影像學檢查結果及出院時基礎狀況。急性腦梗塞成像數(shù)據(jù)采用3.0TMRI檢測,用ImageJ軟件測量并計算腦梗塞體積。多元回歸分析入組患者的腦梗塞體積與左心房內徑、D-二聚體、平均血小板體積、動脈粥樣硬化危險因素、入院及出院時基礎狀況的關系。結果本研究共納入61例患者(男性36例,女性25例),年齡31～93歲,平均年齡為(70.9±11.4)歲,腦梗塞體積0.08～138.90ml,中位數(shù)為20.85ml。雙變量相關分析顯示腦梗塞體積與左心房內徑(r=0.433,P=0.000)、D-二聚體(r=0.487,P==0.000)、平均血小板體積(r=0.397,P=0.002)、入院 NIHSS 評分(r=0.511,P==0.000)、出院NIHSS評分(r=0.412,P=0.000)成正相關,差異具有統(tǒng)計學意義。多元回歸分析顯示腦梗塞體積與左心房內徑、D-二聚體、平均血小板體積顯著相關(P=0.004、P=0.007、P=0.003),差異有統(tǒng)計學意義。結論1.NVAF并發(fā)急性腦梗塞的梗塞體積與左心房內徑大小、D-二聚體水平、平均血小板體積水平與呈正相關。2.NVAF并發(fā)急性腦梗塞的梗塞體積與動脈粥樣硬化危險因素如高血壓、糖尿病、既往腦卒中或者TIA病史、吸煙等不相關。3.NVAF并發(fā)急性腦梗塞的梗塞體積與入院NIHSS評分呈正相關。4.左心房內徑、D-二聚體、平均血小板體積有可能作為預測NVAF并發(fā)急性腦梗塞的梗塞體積的相關指標。
[Abstract]:Objective to retrospectively analyze the relationship between infarct volume and left atrial diameter D-dimer, mean platelet volume, risk factors of atherosclerosis, admission and discharge from patients with acute cerebral infarction in non-valvular atrial fibrillation non-valvular fibrillation (NVAFs). In order to find a possible predictor of non-valvular atrial fibrillation associated with severe cerebral infarction. Methods patients with acute cerebral infarction were selected from September 1, 2014 to September 1, 2016 in Department of Neurology, second Hospital of Jilin University. According to the exclusion criteria, patients with non-valvular atrial fibrillation were selected. The medical records of the patients were reviewed, and their basic information, history of past diseases, history of drug use, basic condition at admission, biochemical indexes after admission, imaging results and basic status at discharge were collected. The imaging data of acute cerebral infarction were measured by 3.0TMRI, and the volume of cerebral infarction was measured and calculated by ImageJ software. Multivariate regression analysis was used to analyze the relationship between cerebral infarction volume and D-dimer, mean platelet volume, risk factors of atherosclerosis, and basic condition at admission and discharge. Results A total of 61 patients (36 males and 25 females) were enrolled in this study. The mean age was 70.9 鹵11.4 years, with a mean age of 70.9 鹵11.4 years. The volume of cerebral infarction was 0.08 鹵138.90 ml, the median was 20.85 ml. The bivariate correlation analysis showed that the volume of cerebral infarction was positively correlated with the left atrial diameter of 0.433P ~ (0.000) and the average platelet volume of 0.487 ~ 0.487 ~ 0.000 ~ 0.000g, the mean platelet volume was 0.397m ~ (0.000), the NIHSS score of admission was 0.511 ~ (0.000), and the NIHSS score was 0.412 ~ (0.000) (P = 0.000), and the difference was statistically significant (P < 0.05). Multiple regression analysis showed that the volume of cerebral infarction was significantly correlated with the diameter of D-dimer and the mean platelet volume of left atrium. Conclusion the infarct volume of 1.NVAF complicated with acute cerebral infarction is positively correlated with the level of D-dimer and the mean platelet volume. 2. The infarct volume of 1.NVAF complicated with acute cerebral infarction and the risk factors of atherosclerosis such as hypertension and diabetes mellitus. There was no correlation between previous stroke or TIA history, smoking and so on. 3. The infarct volume of NVAF complicated with acute cerebral infarction was positively correlated with the admission NIHSS score. 4. D- dimer and mean platelet volume of left atrium may be used as predictors of infarct volume in NVAF complicated with acute cerebral infarction.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3;R541.75

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本文編號：1791995