浙江中西医结合杂志

赖卫平.急性缺血性脑卒中患者肌钙蛋白升高的相关因素分析[J].浙江中西医结合杂志,2013,23(9):706-709

急性缺血性脑卒中患者肌钙蛋白升高的相关因素分析

Analysis on Factors Related with Troponin Elevated in Acute Ischemic Stroke Patients

投稿时间：2013-05-13

DOI：

英文关键词:acute ischemic stroke troponin risk factors

基金项目:

作者	单位
赖卫平	浙江省遂昌县人民医院

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中文摘要:

目的：探讨急性缺血性脑卒中患者血清肌钙蛋白升高的相关因素。方法：回顾性分析 660 例急性缺血性脑卒中患者临床资料包括性别、年龄、病程、合并症如高血压病、高胆固醇血症、糖尿病、既往脑卒中、冠心病、充血性心衰、慢性阻塞性肺疾病、房颤和肾功能不全、 NIHSS 评分、病灶直径、 TOAST病因分型、岛叶累及情况和肌钙蛋白 T （cTnT）水平。应用 Logistic 多元回归进行多因素分析以探讨cTnT 水平升高与相关危险因素之间的关系。结果： 660 例中 102 例（15.5豫） cTnT 水平升高。与cTnT正常组比较， cTnT升高组年龄较大， NIHSS 评分较高，房颤、肾功能不全、冠心病、充血性心衰和岛叶皮质受累更为多见，而高胆固醇血症较少，差异有统计学意义（P<0.05）； Logistic多元回归分析显示，肾功能不全、冠心病、高胆固醇血症、较高的 NIHSS 评分和岛叶皮质受累与 cTnT 的升高独立相关（P<0.05）。结论：急性缺血性脑卒中患者常伴 cTnT升高，对于脑卒中危险分层和诊疗策略的选择具有重要意义。

英文摘要:

Objective： To explore the factors related with increase in troponin in patients with acute ischemic stroke. Methods： A total of 660 patients with acute ischemic stroke were included. Their clinical data were retrospectively reviewed, including gender， age， complications such as hypertension， hypercholesterolemia， diabetes， previous stroke， coronary heart disease， congestive heart failure， chronic obstructive pulmonary disease， atrial fibrillation， and renal in- sufficiency， NIHSS score， TOAST etiology， insular cortex involvement， and cardiac troponinT （cTnT） . Logistic multiple regression analysis was performed to investigate the relationship between increase in cTnT with risk factors. Re- sults： Increase in cTnT was identified in 102 patients（15.5%） . Patients with the cTnT increased were significantly older and had higer NIHSS scores. Atrial fibrillation， renal insufficiency， coronary heart disease， congestive heart fail- ure， and insular cortex involvement were recorded more frequently in the cTnT increased group， whereas HLP pre- sented often less. Logistic regression analysis showed that renal insufficiency， coronary heart disease， hypercholes- terolemia， higher NIHSS score， and insular cortex involvement were independently associated with increase in cTnT. Conclusion： Patients with acute ischemic stroke were often accompanied by cTnT elevated， especially for patients who had high NIHSS score， renal insufficiency， coronary heart disease or insular cortex involvement. It is of great significance for risk stratification and treatment strategies choice.

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