摘要
目的研究动脉支架植入术后缺血性脑卒中复发影响因素及与微栓子信号(MES)的关系。方法回顾分析2015年9月-2018年9月于我院行动脉支架植入术的80例缺血性脑卒中患者临床资料,据术后1年复发情况分为复发组28例和未复发组52例。比较两组一般情况、病史、MES阳性及血小板计数、总胆固醇、甘油三酯(TG)水平等资料;利用受试者工作特征(receiver operating curve,ROC)曲线分析血小板计数、TG水平预测动脉支架植入术后缺血性脑卒中复发的价值;利用Logistic回归分析模型分析动脉支架植入术后缺血性脑卒中复发的影响因素。结果复发组有高血压病史、卒中家族史、颈动脉斑块、MES阳性者比例及血小板计数、TG水平显著高于未复发组(P<0.05或P<0.01)。ROC分析显示:血小板计数、TG预测动脉支架植入术后缺血性脑卒中复发的曲线下面积分别为0.796、0.765。经Logistic回归分析显示,血小板计数>249.1×109/L、TG>1.565 mmol/L、有高血压病史、有卒中家族史、存在颈动脉斑块、MES阳性是动脉支架植入术后缺血性脑卒中复发的危险因素(P<0.05或P<0.01)。结论缺血性脑卒中患者动脉支架植入术后血小板计数、TG高水平及MES阳性、颈动脉斑块形成可能预示有复发风险,临床医师需予持续关注,及时干预以减少缺血性脑卒中复发。
Objective To study the factors influencing the recurrence of ischemic stroke and their relationship with MES.Methods The clinical data of 80 patients with ischemic stroke who underwent artery stent implantation in our hospital from September 2015 to September 2018 were analyzed retrospectively.According to the recurrence at 1-year follow-up,the patients were divided into recurrence group(recurrence of ischemic stroke within one year,n=28)and non-recurrence group(no stroke or other brain diseases within one year,n=52).The general condition,medical history,positive MES,blood platelet count(BPC),cholesterol(TC),and triglyceride(TG)levels of the two groups were compared.Receiver operating curve(ROC)was used to analyze the value of BPC and TG level in predicting the recurrence of ischemic stroke after artery stent implantation.Influencing factors of ischemic stroke recurrence were analyzed by logistic regression analysis model.Results The proportion of history of hypertension,family history of stroke,carotid plaque,positive MES in recurrence group as well as BPC and TG levels were significantly higher than those in non-recurrence group(P<0.05 or P<0.01).ROC analysis showed that the area under the curve of BPC and TG for predicting recurrence of ischemic stroke after artery stent implantation was 0.796 and 0.765 respectively.Logistic regression analysis confirmed that BPC>249.1×109/L,TG>1.565 mmol/L,hypertension,family history of stroke,carotid plaque and positive MES were the risk factors for the recurrence of ischemic stroke after artery stent implantation(P<0.05 or P<0.01).Conclusion The high expression of BPC and TG,positive MES and the formation of carotid plaque may indicate the risk of recurrence of ischemic stroke.Therefore,clinicians need to give continuous attention and timely intervention to reduce the recurrence of ischemic stroke.
作者
王亚
于彩敏
平会坤
代红兰
刘丽
WANG Ya;YU Cai-min;PING Hui-kun;DAI Hong-lan;LIU Li(Department of Ultrasonography,People's Hospital of Dingzhou,Baoding,Hebei 073000,China;Department of Neurology,People's Hospital of Dingzhou,Baoding,Hebei 073000,China)
出处
《临床误诊误治》
2020年第10期100-104,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划项目(20191750)。
