【摘要】：目的：探討冠心病與后循環(huán)梗死的相關(guān)性及其對預(yù)后的影響。方法：本研究屬于回顧性病例-對照研究，研究對象為2012年3月-2014年1月在新疆維吾爾自治區(qū)人民醫(yī)院收治的急性腦梗死患者，，以年齡、性別匹配的正常體檢者作為正常對照組。按照梗死部位將急性腦梗死分成后循環(huán)梗死組、前循環(huán)梗死組；按30天隨訪時mRS得分來分為預(yù)后不良組（3-6分）與預(yù)后良好組（0-2分）組。收集人口學(xué)資料、血管病危險因素和影像學(xué)資料，采用單因素和多因素logistic回歸分析的方法，評估冠心病與腦梗死、前循環(huán)梗死和后循環(huán)梗死的相關(guān)性，評估前、后循環(huán)梗死不良預(yù)后的危險因素。結(jié)果：急性腦梗死371例，符合納入標(biāo)準(zhǔn)343例，其中前循環(huán)梗死204例，后循環(huán)梗死139例。正常對照139例。前循環(huán)梗死組合并冠心病57例（27.94%），后循環(huán)梗死組合并冠心病40例（28.78%）。正常對照組診斷冠心病22例（15.82%）。多因素分析結(jié)果顯示，后循環(huán)梗死的危險因素有冠心�。∣R2.052，95%CI1.316-3.198，P=0.002）、高血壓（OR3.539，95%CI1.955-6.405，P=0.001）、C反應(yīng)蛋白（OR1.064，95%CI1.009-1.112，P=0.023）。隨訪30天時的mRS結(jié)果顯示，后循環(huán)梗死組預(yù)后良好92例（66.18%），預(yù)后不良47例（33.8%）。影響后循環(huán)梗死預(yù)后的危險因素有冠心�。∣R0.225，95%CI0.08-0.65，P0.01）、入院時NIHSS評分（OR8.702，95%CI3.51-21.58，P0.01）、入院時GCS（OR3.433，95%CI1.05-12.44，P=0.03）、脈壓（OR0.469，95%CI0.2-0.95，P=0.037）。結(jié)論：后循環(huán)梗死的危險因素有冠心病、高血壓和C反應(yīng)蛋白。影響后循環(huán)梗死預(yù)后主要的因素包括：冠心病、脈壓、GCS評分、NIHSS評分。
[Abstract]:Objective: To study the correlation between coronary heart disease and post-cycle infarction and its effect on prognosis. Methods: This study was a retrospective case-control study. The subjects of the study were the patients with acute cerebral infarction treated in the People's Hospital of Xinjiang Uygur Autonomous Region from March to January,2014. The normal physical examination with age and sex was used as the normal control group. The patients with acute cerebral infarction were divided into the following group (3-6) and the group (0-2) of the prognosis group according to the mRS score at 30-day follow-up. Demographic data, risk factors and imaging data were collected. The correlation between coronary heart disease and cerebral infarction, pre-circulating infarction and post-circulatory infarction was assessed by single-factor and multi-factor logistic regression, and the risk factors of the poor prognosis of the pre-and post-circulatory infarction were assessed. Results: In 371 cases of acute cerebral infarction, there were 343 cases of acute cerebral infarction, including 204 cases of pre-circulating infarction and 139 cases of post-circulatory infarction. The normal control was 139 cases. There were 57 cases (27.94%) of anterior circulation infarction, and 40 (28.78%) of coronary heart disease. In the normal control group,22 cases (15.82%) of coronary heart disease were diagnosed. Multivariate analysis showed that the risk factors of post-circulation infarction were coronary heart disease (ORR2.052,95% CI 1.316-3.198, P = 0.002), hypertension (OR3.539,95% CI,955-6.405, P = 0.001), and C-reactive protein (ORR1.064,95% CI1.009-1.112, P = 0.023). The results of mRS at 30 days of follow-up showed that the prognosis of the posterior circulation infarction group was good in 92 cases (66.18%) and the prognosis was poor (33.8%). There were coronary heart disease (OR0.225,95% CI 0.08-0.65, P0.01), NIHSS score (OR8.702,95% CI 3.51-21.58, P0.01) at admission, GCS (OR3.433,95% CI1.05-12.44, P = 0.03) and pulse pressure at admission (OR0.469,95% CI 0.2-0.95, P = 0.037). Conclusion: The risk factors of post-circulation infarction include coronary heart disease, hypertension and C-reactive protein. The factors that affect the prognosis of post-circulation infarction include coronary heart disease, pulse pressure, GCS score and NIHSS score.
【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;R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 阮永龍;李飛;付恩鴻;王鋒;;急性腦梗死OCSP分型及Adams分型與心電圖異常的對比研究[J];安徽醫(yī)學(xué);2009年04期

2 季濤云;張月華;李飛天;秦炯;楊艷玲;;以周圍神經(jīng)損傷為主要表現(xiàn)的甲基丙二酸尿癥合并同型半胱氨酸血癥1例[J];北京大學(xué)學(xué)報(醫(yī)學(xué)版);2013年02期

3 劉寧;布艾加爾·哈斯木;;前后循環(huán)腦梗死患者動態(tài)血壓特點分析[J];海南醫(yī)學(xué)院學(xué)報;2012年04期

4 陳荷花;;護(hù)理干預(yù)對老年冠心病患者危險因素的控制與影響分析[J];中外醫(yī)療;2012年16期

5 吉維忠;范麗君;郝文莉;宋梅;戴雁;;后循環(huán)急性多發(fā)腦梗死36例臨床分析[J];吉林醫(yī)學(xué);2010年07期

6 溫蘭娟;;后循環(huán)腦梗死危險因素分析[J];吉林醫(yī)學(xué);2012年17期

7 辛勇通;姚龍騰;黃艮彬;魏鼎泰;齊育英;;后循環(huán)梗死CISS亞型危險因素分析[J];中國實用神經(jīng)疾病雜志;2013年05期

8 姜貝思;董強(qiáng);;446例急性缺血性腦卒中患者早期持續(xù)心電圖異常對預(yù)后不利影響的多中心前瞻性研究[J];中國臨床神經(jīng)科學(xué);2013年03期

9 郭義坤;施國文;李焰生;;后循環(huán)梗死患者的危險因素及預(yù)后分析[J];上海交通大學(xué)學(xué)報(醫(yī)學(xué)版);2010年11期

10 劉學(xué)源;;后循環(huán)缺血研究進(jìn)展[J];上海醫(yī)學(xué);2010年12期

本文編號：2455025