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目的探讨导致发展为进展性脑梗死的可控临床因素。方法 458例脑梗死患者,其中113例进展性脑梗死患者为进展组,其余345例脑梗死患者为非进展组。分析两组的病史资料和临床指标。病史资料包括吸烟史、卒中病史、高血压病史、糖尿病病史、短暂性脑缺血发作病史、高脂血症病史。临床指标资料包括:发热、白细胞增多、收缩压>160 mm Hg(1 mm Hg=0.133 k Pa)、脉压差<40 mm Hg、高血糖、高胆固醇、高甘油三酯。结果进展组的高血压病史94.9%、糖尿病病史27.4%高于非进展组59.7%、19.1%,差异有统计学意义(P<0.05)。进展组中发热、收缩压>160 mm Hg、脉压差<40 mm Hg、高血压、高甘油三酯所占比例高于非进展组,差异有统计学意义(P<0.05)。结论导致发展为进展性脑梗死的可控临床因素有高血压、高血糖、脉压过低、感染发热、高脂血症等,控制上述因素有助于减少脑梗死发展为进展性脑梗死。
Objective To explore the controlled clinical factors leading to the development of progressive cerebral infarction. Methods 458 patients with cerebral infarction, 113 patients with progressive cerebral infarction in progress group, the remaining 345 patients with cerebral infarction were non-progressing group. Analysis of the two groups of medical history data and clinical indicators. History data include smoking history, history of stroke, history of hypertension, history of diabetes, history of transient ischemic attack, history of hyperlipidemia. Clinical data included fever, leukocytosis, systolic blood pressure> 160 mm Hg (1 mm Hg = 0.133 kPa), pulse pressure difference <40 mm Hg, hyperglycemia, high cholesterol, and high triglycerides. Results The history of hypertension was 94.9% in the progressing group and 27.4% in the history of diabetes mellitus (59.7%, 19.1%). The difference was statistically significant (P <0.05). Progressive group fever, systolic blood pressure> 160 mm Hg, pulse pressure difference <40 mm Hg, hypertension, high triglyceride proportion was higher than non-progress group, the difference was statistically significant (P <0.05). Conclusions The controlled clinical factors leading to the development of progressive cerebral infarction are hypertension, hyperglycemia, low pulse pressure, fever and hyperlipidemia. Controlling the above factors may help to reduce the development of cerebral infarction into progressive cerebral infarction.