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1、進(jìn)展性缺血性腦卒中危險(xiǎn)因素的臨床研究摘要目的:探討引起進(jìn)展性缺血性腦卒中發(fā)生的危險(xiǎn)因素,為其臨床預(yù)防及診治提供參考。方法:選擇2013年12月一2014年12月在山西醫(yī)科大學(xué)第二醫(yī)院神經(jīng)內(nèi)科住院的缺血性腦卒中患者123例,其中為進(jìn)展性腦卒中的有34例,作為進(jìn)展組;非進(jìn)展腦卒中患者89例,作為非進(jìn)展組。研究?jī)山M病人的既往史(糖尿病病史、腦卒中病史、高血壓病病史、冠心病病史)和個(gè)人史(吸煙史、飲灑史),生化指標(biāo)(空腹血糖、血尿酸、D—二聚體、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、總膽固醇、甘油三酯、同型半胱氨酸、超敏C-反應(yīng)蛋白),頸動(dòng)脈不穩(wěn)定斑塊16個(gè)因素。首先對(duì)上訴的各相關(guān)因素進(jìn)行單因素的X
2、?檢驗(yàn),對(duì)有統(tǒng)計(jì)學(xué)意義的因素作為自變量進(jìn)行Logistic冋歸分析。結(jié)果:進(jìn)展組和非進(jìn)展組之間的16個(gè)因素進(jìn)行£檢驗(yàn),以P<0.05為有統(tǒng)計(jì)學(xué)意義,其中有統(tǒng)計(jì)學(xué)意義的因素有7個(gè),分別是糖尿病病史、腦卒中病史、空腹血糖、D-二聚體、低密度脂蛋白膽固醇、同型半胱氨酸、頸動(dòng)脈不穩(wěn)定斑塊。以缺血性腦卒中是否發(fā)生進(jìn)展為因變量,把上訴有統(tǒng)計(jì)學(xué)意義的單因素作為自變量進(jìn)行多因素的Logistic回歸分析,經(jīng)Logistic回歸分析得出:空腹血糖、糖尿病病史、低密度脂蛋白膽固醇高、頸部不穩(wěn)定斑塊、高同型半胱氨酸有顯著性意義,而D-二聚體、腦卒中病史無(wú)顯著性意義。結(jié)論:空腹血糖、糖尿病病史、低密度脂蛋口膽固醇高、
3、頸部不穩(wěn)定斑塊、同型半胱氨酸是引起缺血性腦卒中發(fā)生進(jìn)展的主要危險(xiǎn)因素,在臨床工作中應(yīng)予以積極預(yù)防及治療有上訴危險(xiǎn)因素的急性腦卒中患者,降低進(jìn)展性腦卒中的發(fā)生率。尖鍵詞:進(jìn)展性缺血性腦卒中;非進(jìn)展性缺血性腦卒中;影響因素TheclinicalstudyofRiskFactorsofProgressingIschemicStrokeAbstractObjective:Todiscusstherelatedriskfactorsofprogressiveischemicstroke,providingthemedicaladvicesforthepreventionandclinicaldiagno
4、sisandtreatment.Methods:Clinicaldataof123casesofpatientswithischemicstrokeinthesecondhospitalofShanxiMedicalUniversityneurologyfromDecember2013toDecember2014wereselected,34patientswereprogressingischemicstroke,wouldbeastheprogressinggroup,andtheother89patientswerenotprogressiveischemicstroke,astheno
5、tprogressgroup.Aretrospectiveanalysisoftwogroupsofpatientswithpasthistory(historyofhighbloodpressure,historyofdiabetesmellitus,historyofcoronaryheartdisease,historyofstroke),andpersonalhistory(smokinghistory,drinkinghistory),biochemicalindicators(fastingbloodglucose,D一Dimer,lowdensitylipoproteinchol
6、esterol,highdensitylipoproteincholesterol,totalcholesterol,triglyceride,homocysteine,highsensitiveC?reactiveprotein,blooduricacid),andneckunstableplaque.Firstly,Therelatedfactorsofappealwerescreenedbysinglefactoranalysistothechisquaretest,theriskofStatisticalsignificancefactorastheindependentvariabl
7、ebyLogisticregressionanalysis.Results:16factorsbetweentheprogressingandnotprogressinggroupswereanalyzedwithchisquaretest,forP<0.05hasthestatisticalsignificant.7factorshadthesignificant,theywerethehist