本文關(guān)鍵詞： 腦靜脈竇血栓形成 預(yù)后危險(xiǎn)因素 D-二聚體 治療　出處：《新疆醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討腦靜脈竇血栓形成(cerebral venous sinus thrombosis, CVST)患者短期轉(zhuǎn)歸不良的預(yù)測因素。方法：回顧性分析42例CVST患者的臨床資料,根據(jù)出院時改良Rankin量表(modified Rankin Scale, mRS)評價臨床轉(zhuǎn)歸,將病例組分為轉(zhuǎn)歸良好組(0-1分)和轉(zhuǎn)歸不良組(3-6分)。比較兩組人口統(tǒng)計(jì)學(xué)、病因、臨床特征等相關(guān)因素,采用多變量logistic回歸分析確定CVST患者短期轉(zhuǎn)歸不良的獨(dú)立預(yù)測因素,利用受試者工作特征曲線(receiver operating characteristic curve, ROC)分析確定其預(yù)測價值。結(jié)果：42例CVST患者mRS評分0分3例,1分10例,2分16例,3-5分11例,6分2例；31%的患者轉(zhuǎn)歸不良,病死率為4.8%。單因素分析顯示,轉(zhuǎn)歸良好組與轉(zhuǎn)歸不良組之間的中樞神經(jīng)系統(tǒng)感染、惡性腫瘤、妊娠、產(chǎn)褥期、口服避孕藥或激素替代治療、高同型半胱氨酸血癥、治療方式和基線D-二聚體水平存在顯著性差異。多變量logistic回歸分析顯示,基線D-二聚體水平990ng/ml是CVST患者短期轉(zhuǎn)歸不良的獨(dú)立預(yù)測因素(優(yōu)勢比1.006,95%可信區(qū)間1.002-1.011；P=0.005),抗凝聯(lián)合溶栓治療是CVST患者短期轉(zhuǎn)歸不良的獨(dú)立保護(hù)因素(優(yōu)勢比0.027,95%可信區(qū)間0.002-0.447；P=0.033)。ROC曲線分析顯示,基線D-二聚體截?cái)嘀禐?90ng/ml時,其預(yù)測CVST短期轉(zhuǎn)歸不良的敏感性為76.9%,特異性為86.2%。結(jié)論：基線D-二聚體水平990ng/ml是CVST患者短者轉(zhuǎn)歸不良的獨(dú)立預(yù)測因素；CVST患者實(shí)施抗凝聯(lián)合溶栓治療效果最佳。
[Abstract]:Objective: To investigate the cerebral venous sinus thrombosis (cerebral venous sinus thrombosis, CVST) the short-term prognostic factor in patients with poor outcome. Methods: retrospective analysis of the clinical data of 42 patients with CVST, according to the modified Rankin scale (modified Rankin Scale, mRS) to evaluate the clinical outcomes of the patients were divided into good outcome group (0-1) and poor outcome group (3-6). Comparison of two groups of demographics, etiology, clinical features and related factors, multivariate logistic regression analysis was used to identify independent predictors of CVST in patients with short-term outcome, using the receiver operating characteristic curve (receiver operating characteristic curve, ROC) analysis to determine its predictive value. Results: 42 cases of CVST patients with mRS score of 0 points in 3 cases, 1 cases were 10, 2 in 16 cases, 3-5 cases were 11, 6 in 2 cases; 31% patients with bad prognosis, the mortality rate was 4.8%. single factor analysis showed that a good outcome group With the infection of central nervous system adverse outcome between groups of malignant tumor, pregnancy, puerperium, oral contraceptives or hormone replacement therapy, hyperhomocysteinemia, treatment and baseline D- two dimer level there are significant differences. Multivariate logistic regression analysis showed that baseline D- two dimer level of 990ng/ml were independent prognostic factors the short-term outcome of patients with CVST (odds ratio 1.006,95% CI 1.002-1.011; P=0.005), anticoagulation combined thrombolytic therapy is an independent protective factor for CVST patients with poor prognosis (odds ratio 0.027,95% CI 0.002-0.447; P=0.033).ROC curve analysis showed that baseline D- two dimer cutoff value is 990ng/ml, the sensitivity of CVST to predict short-term outcome is 76.9%, the specificity was 86.2%. conclusion: D- two baseline level of D-dimer in patients with CVST 990ng/ml is short of independent factors predicting poor outcome in patients with CVST; The effect of anticoagulant combined with thrombolytic therapy is the best.

【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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