心脑血管病防治2025，Vol.25Issue(12)：14-18,28,6.DOI:10.3969/j.issn.1009-816x.2025.12.003
急性脑梗死进展为急性进展性脑梗死的危险因素及预后分析
Risk factors and prognostic analysis of acute cerebral infarction progressing to acute progressive cerebral infarction
摘要
Abstract
Objective To explore the risk factors for acute progressive cerebral infarction(APCI)and their impact on prognosis.Methods A total of 480 patients with acute cerebral infarction(ACI)admitted to the department of neurology at Xingtai Central Hospital from February 2022 to December 2022 were selected as the study subjects.Based on whether their condition progressed to APCI,the patients were divided into Group A(160 cases,progressed to APCI)and Group AN(320 cases,did not progress to APCI).Clinical data on admission were collected and compared.All ACI patients were classified using the TOAST and OCSP classification systems,and the distribution between groups was compared.Multivariate Logistic regression analysis was performed to identify factors influencing the progression from ACI to APCI.Patient prognosis was assessed at 30 days and 90 days after onset using the Activities of Daily Living(ADL)scale to evaluate independent living ability,the modified Rankin Scale(mRS)to assess disability and neurological function,and data on recurrent cerebral infarction and mortality were collected.Results Group A accounted for 33.33%of all ACI patients.Compared with Group AN,Group A had a significantly higher proportion of patients with systolic blood pressure≥140 mmHg(χ2=6.771,P<0.05),higher fasting blood glucose level(t=2.201,P<0.05),a greater proportion of large artery atherosclerosis(LAA)subtype(χ2=14.320,P<0.05),and a lower proportion of patients with onset-to-admission time within 0-6 hours(χ2=21.686,P<0.05).Multivariate Logistic regression analysis identified elevated fasting blood glucose,systolic blood pressure≥140 mmHg,TOAST classification(LAA),and onset-to-admission time>6 h as risk factors for the progression from ACI to APCI.Compared with Group AN,Group A showed significantly higher ADL scores at both 30 days and 90 days(t=5.113,9.942;P<0.05),and lower mRS scores(t=4.893,9.577;P<0.05).Moreover,the 30-day recurrence rate of cerebral infarction was significantly higher in Group A than in Group AN(χ2=7.340,P<0.05).Conclusion Elevated fasting blood glucose,systolic blood pressure≥140 mmHg,TOAST classification(LAA),and onset-to-admission time>6 h are risk factors for the progression from ACI to APCI.Patients with APCI have a poorer prognosis.关键词
急性脑梗死/急性进展性脑梗死/危险因素/临床分型/预后Key words
Acute cerebral infarction/Acute progressive cerebral infarction/Risk factors/Clinical classification/Prognosis引用本文复制引用
张潇,王美蓉,庞学波,尹世策,孔咏梅..急性脑梗死进展为急性进展性脑梗死的危险因素及预后分析[J].心脑血管病防治,2025,25(12):14-18,28,6.基金项目
邢台市重点研发计划项目(2021ZC096) （2021ZC096）
