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目的探讨不同亚型急性脑梗死短期不良结局的危险因素。方法以3 231例急性脑梗死住院患者为研究对象,收集人口统计学、生活方式、疾病史、心血管病家族史、入院血压、实验室检测结果及出院结局等临床资料。将出院时美国国立卫生研究脑率中量表(NIHSS)≥10或住院期间死亡定义为不良结局。应用Logistic回归方法进行统计分析。结果脑栓塞者不良结局的发生率最高,其次是脑血栓者,腔隙性梗死者最低。吸烟(OR:1.228;95% CI:1.013～1.637;P=0.039),血脂异常(OR:1.264;95% CI:1.081～1.478;P=0.003),糖尿病(OR:1.371;95 %CI:1.075～1.747;P=0.011)与脑血栓的不良结局相关联;心房纤颤(OR:3.131;95% CI:1.206～8.128;P=0.019)和风湿性心脏病(OR:5.601;95% CI:1.561～20.091;P=0.008)与脑栓塞的不良结局相关联;年龄(1.011;95% CI,1.003～1.02))和饮酒(OR:1.428;95% CI:1.063～1.919;P=0.018)与腔隙性脑梗死的不良结局相关联。结论脑栓塞患者不良结局的发生率最高;在3种脑梗死亚型中,与短期不良结局相关联的危险因素并不相同。
Objective To investigate the risk factors of short-term adverse outcomes in patients with different subtypes of acute cerebral infarction. Methods A total of 3 231 hospitalized patients with acute cerebral infarction were enrolled in this study. Clinical data including demographics, life style, history of disease, family history of cardiovascular disease, admission blood pressure, laboratory test results and discharge outcomes were collected. The NIH Sense Scale ≥10 or hospital-based death at discharge from hospital was defined as a poor outcome. Logistic regression method was used for statistical analysis. Results Cerebral embolism had the highest incidence of adverse outcomes, followed by cerebral thrombosis with the lowest lacunar infarct size. (OR: 1.228; 95% CI: 1.013-1.637; P = 0.039), dyslipidemia (OR: 1.264; 95% CI: 1.081-1.478; (OR: 3.131; 95% CI: 1.206-8.128; P = 0.019) and rheumatic heart disease (OR: 5.601; 95% CI: -1.747; P = 0.011) were associated with adverse outcomes of cerebral thrombosis; (OR = 1.428; 95% CI: 1.063-1.919; P = 0.018) with age (1.011; 95% CI, 1.003-1.02) Lacunar infarction associated with adverse outcomes. Conclusions The incidence of adverse outcomes in patients with cerebral embolism is highest; among the three subtypes of cerebral infarction, the risk factors associated with short-term adverse outcomes are not the same.