轻型缺血性卒中早期神经功能恶化的基线预测因素

被引：23

作者：

时蒙蒙 ^{[1
]}

闫福岭 ^{[2
]}

姬海超 ^{[2
]}

机构：

[1] 天津市第五中心医院脑血管病治疗中心

[2] 东南大学附属中大医院神经内科

来源：

临床神经病学杂志 | 2015年 / 28卷 / 05期

关键词：

轻型缺血性卒中; 早期神经功能恶化; 危险因素; 症状性颅内外动脉重度狭窄或闭塞;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

100204 [神经病学];

摘要：

目的明确轻型缺血性卒中早期神经功能恶化（END）的发生率及基线预测因素。方法连续入选发病72 h内入院的急性轻型缺血性卒中患者。采用单变量分析和多变量Logistic回归分析对基线人口学资料、缺血性卒中危险因素、临床资料、实验室资料及影像学资料进行分析,明确轻型缺血性卒中END的危险因素。结果从2012年6月2013年8月共有319例患者入组并纳入分析,其中45例（14.1%）患者发生END。单变量分析显示,END组的基线NIHSS（U=3522.000,P=0.000）、基线收缩压（t=2.871,P=0.004）、症状性颅内外大血管重度狭窄或闭塞患者所占的比例（χ2=52.564,P=0.000）、大动脉粥样硬化型病因分型所占的比例（χ2=47.287,P=0.000）显著高于无END组。多变量Logistic回归分析显示,基线收缩压>142mm Hg（1 mm Hg=0.133 k Pa）(OR=3.954,95%CI:1.693～9.236,P=0.001)、症状性颅内外动脉重度狭窄或闭塞（OR=3.170,95%CI:1.170～8.583,P=0.023）、基线NIHSS较高（OR=2.038,95%CI:1.359～3.057,P=0.001）与END显著相关。结论约14.1%的轻型缺血性卒中患者可发生END。基线收缩压>142 mm Hg、症状性颅内外大血管重度狭窄或闭塞、基线NIHSS较高是轻型缺血性卒中END的独立危险因素。

引用

页码：345 / 348

页数：4

共 10 条

[1]

Perfusion MR Predicts Outcome in High-Risk Transient Ischemic Attack/Minor Stroke.[J].Negar Asdaghi;Michael D. Hill;Jonathan I. Coulter;Kenneth S. Butcher;Jayesh Modi;Abdul Qazi;Mayank Goyal;Andrew M. Demchuk;Shelagh B. Coutts.Stroke.2013, 9

[2]

Outcomes in Mild or Rapidly Improving Stroke Not Treated With Intravenous Recombinant Tissue-Type Plasminogen Activator: Findings From Get With The Guidelines–Stroke.[J].Eric E. Smith;Gregg C. Fonarow;Mathew J. Reeves;Margueritte Cox;DaiWai M. Olson;Adrian F. Hernandez;Lee H. Schwamm.Stroke.2011, 11

[3]

MRI Findings May Predict Early Neurologic Deterioration in Acute Minor Stroke or Transient Ischemic Attack due to Intracranial Atherosclerosis [J].

Kim, Joon-Tae ;

Kim, Hye-Jin ;

Yoo, Sung-Hee ;

Park, Man-Seok ;

Kwon, Sun U. ;

Cho, Ki-Hyun ;

Kim, Jong S. ;

Kang, Dong-Wha .

EUROPEAN NEUROLOGY, 2010, 64 (02) :95-100

[4]

What Is a Minor Stroke? [J].

Fischer, Urs ;

Baumgartner, Adrian ;

Arnold, Marcel ;

Nedeltchev, Krassen ;

Gralla, Jan ;

De Marchis, Gian Marco ;

Kappeler, Liliane ;

Mono, Marie-Luise ;

Brekenfeld, Caspar ;

Schroth, Gerhard ;

Mattle, Heinrich P. .

STROKE, 2010, 41 (04) :661-666

[5]

Hemodynamic Factors and Perfusion Abnormalities in Early Neurological Deterioration [J].

Alawneh, Josef A. ;

Moustafa, Ramez Reda ;

Baron, Jean-Claude .

STROKE, 2009, 40 (06) :E443-E450

[6]

Recurrent events in transient ischemic attack and minor stroke - What events are happening and to which patients? [J].

Coutts, Shelagh B. ;

Hill, Michael D. ;

Campos, Cynthia R. ;

Choi, Young B. ;

Subramaniam, Suresh ;

Kosior, Jayme C. ;

Demchuk, Andrew M. .

STROKE, 2008, 39 (09) :2461-2466

[7]

Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies [J].

Lovett, JK ;

Coull, AJ ;

Rothwell, PM .

NEUROLOGY, 2004, 62 (04) :569-573

[8]

Trial Design and Reporting Standards for Intra-Arterial Cerebral Thrombolysis for Acute Ischemic Stroke.[J].Randall T. Higashida;Anthony J. Furlan.Stroke: Journal of the American Heart Association.2003, 8

[9]

Why are stroke patients excluded from TPA therapy? An analysis of patient eligibility [J].

Barber, PA ;

Zhang, J ;

Demchuk, AM ;

Hill, MD ;

Buchan, AM .

NEUROLOGY, 2001, 56 (08) :1015-1020

[10]

CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].

ADAMS, HP ;

BENDIXEN, BH ;

KAPPELLE, LJ ;

BILLER, J ;

LOVE, BB ;

GORDON, DL ;

MARSH, EE ;

KASE, CS ;

WOLF, PA ;

BABIKIAN, VL ;

LICATAGEHR, EE ;

ALLEN, N ;

BRASS, LM ;

FAYAD, PB ;

PAVALKIS, FJ ;

WEINBERGER, JM ;

TUHRIM, S ;

RUDOLPH, SH ;

HOROWITZ, DR ;

BITTON, A ;

MOHR, JP ;

SACCO, RL ;

CLAVIJO, M ;

ROSENBAUM, DM ;

SPARR, SA ;

KATZ, P ;

KLONOWSKI, E ;

CULEBRAS, A ;

CAREY, G ;

MARTIR, NI ;

FICARRA, C ;

HOGAN, EL ;

CARTER, T ;

GURECKI, P ;

MUNTZ, BK ;

RAMIREZLASSEPAS, M ;

TULLOCH, JW ;

QUINONES, MR ;

MENDEZ, M ;

ZHANG, SM ;

ALA, T ;

JOHNSTON, KC ;

ANDERSON, DC ;

TARREL, RM ;

NANCE, MA ;

BUDLIE, SR ;

DIERICH, M ;

HELGASON, CM ;

HIER, DB ;

SHAPIRO, RA .

STROKE, 1993, 24 (01) :35-41

← 1 →