Analysis of the risk factors for poor prognosis of progressive cerebral infarction / 中国基层医药

ABSTRACT

Objective@#To analyze the risk factors affecting the poor prognosis of progressive cerebral infarction.@*Methods@#The clinical data of 326 patients with cerebral infarction admitted to Dermatology and Venereal Disease Prevention and Cure Hospital of Zaozhuang from January 2013 to March 2017 were retrospectively analyzed.The patients were divided into poor prognosis group(n=148) and good prognosis group(n=178) according to their prognosis during hospitalization.Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors affecting prognosis.@*Results@#Statistical analysis showed that there were no statistically significant differences in sex composition, average age, diastolic blood pressure, LDL, anterior cerebral artery stenosis, posterior cerebral artery stenosis and vertebral basilar artery stenosis between the two groups (all P>0.05). The incidence rates of hypertension history (60.81% vs. 48.88%, χ2=1.683, P=0.031), diabetes history (41.89% vs. 30.90%, χ2=4.244, P=0.039), hyperlipidemia history (62.84% vs. 49.44%, χ2=5.875, P=0.015) in the poor prognosis group were higher than those in the good prognosis group.The systolic blood pressure in poor prognosis group was lower than that in the good prognosis group [(144±17)mmHg vs. (150±22)mmHg, t=2.928, P=0.004]. The body temperature[(38.10±0.22)℃ vs. (38.03±0.34)℃, t=2.240, P=0.026], FPG[(7.85±1.95)mmol/L vs. (6.91±1.77)mmol/L, t=4.558, P=0.000], TC[(5.21±1.66)mmol/L vs. (4.84±1.55)mmol/L, t=2.708, P=0.039], TG[(2.49±0.79 mmol/L vs. (2.30±0.54)mmol/L, t=2.483, P=0.014], HDL [(1.30±0.51)mmol/L vs. (1.17±0.44)mmol/L, t=2.470, P=0.014] and FIB[(4.37±1.67)g/L vs. (3.79±1.42)g/L, t=3.339, P=0.001], stenosis of internal carotid artery (31.08% vs. 20.79%, χ2=4.636, P=0.031), stenosis of middle cerebral artery(39.86% vs. 29.21%, χ2=4.083, P=0.043), and plaque of internal carotid artery (48.65% vs. 36.52%, χ2=4.882, P=0.027) in the poor prognosis group were higher than those in the good prognosis group.Multivariate regression analysis showed that history of hypertension, diabetes, hyperlipidemia, fever, decreased blood pressure, elevated TC, elevated TG, elevated HDL and elevated FIB were the risk factors for the prognosis of progressive cerebral infarction.@*Conclusion@#There are many risk factors affecting the poor prognosis of progressive cerebral infarction, and the physiological mechanism is complex.In clinical treatment, attention should be paid to patients' past diseases, prevention and treatment should be carried out according to different mechanisms.