急性缺血性脑卒中发生早期神经功能恶化影响因素的研究进展
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摘要
国内外研究对于急性缺血性脑卒中病人发生早期神经功能恶化的影响因素有一定的共识,如感染、高血压、糖尿病等,但仍存在不同观点;大量研究显示急性缺血性脑卒中早期神经功能恶化的影响因素众多,包括初始神经功能损伤严重程度、自身因素。由于缺血性脑卒中发病机制存在个体差异性,应规范临床医护人员对发生早期神经功能恶化的影响因素进行系统性评估,为病人提供针对性治疗及护理干预,从而提高其预后。
Domestic and foreign studies have certain consensus on the factors affecting early neurological deterioration(END)in patients with acute ischemic stroke(AIS),such as infection,hypertension,diabetes,etc.,but there are still different opinions;a large number of studies showed that there are many factors influencing the END in AIS,including the severity of initial neurological damage and its own factors.Since the individual differences in the pathogenesis of ischemic stroke,clinical stuff should be standardized to systematically evaluate the influencing factors of END,and provide targeted treatment and nursing intervention to improve the prognosis.
Domestic and foreign studies have certain consensus on the factors affecting early neurological deterioration(END)in patients with acute ischemic stroke(AIS),such as infection,hypertension,diabetes,etc.,but there are still different opinions;a large number of studies showed that there are many factors influencing the END in AIS,including the severity of initial neurological damage and its own factors.Since the individual differences in the pathogenesis of ischemic stroke,clinical stuff should be standardized to systematically evaluate the influencing factors of END,and provide targeted treatment and nursing intervention to improve the prognosis.
引文
[1]张丽君,刘耿星,张丽娟.动态血压监测与脑卒中关系研究[J].中国实用神经疾病杂志,2014,17(5):42-43.
[2]ALVAREZ-SABIN J,MAISTERRA O,SANTAMARINA E,et al.Factors influencing haemorrhagic transformation in ischaemic stroke[J].Lancet Neurol,2013,12(7):689-705.
[3]靳贵生,李伟,张建斌.缺血性脑卒中早期神经功能恶化的影响因素及参麦注射液对其疗效的研究[J].中华神经医学杂志,2013,12(9):914-918.
[4]SENERS P,TURC G,OPPENHEIM C,et al.Incidence,causes and predictors of neurological deterioration occurring within 24h following acute ischaemic stroke:a systematic review with pathophysiological implications[J].J Neurol Neurosurg Psychiatry,2015,86(1):87-94.
[5]杨吉军,谢礼,桂培根,等.房颤对急性缺血性脑卒中严重程度和早期死亡的影响[J].中南医学科学杂志,2017,45(3):263-265.
[6]童宁.动态血压与缺血性脑卒中早期神经功能恶化的关系[J].中国实用神经疾病杂志,2016,19(8):7-9.
[7]LEE S J,HONG J M,LEE S E,et al.Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes[J].BMC Neurol,2017,17(1):101.
[8]SIEGLER J E,BOEHME A K,KUMAR A D,et al.What change in the National Institutes of Health Stroke Scale should define neurologic deterioration in acute ischemic stroke?[J].J Stroke Cerebrovasc Dis,2013,22(5):675-682.
[9]李瑞英,陈会生.急性缺血性脑卒中早期神经功能恶化研究现状及进展[J].临床军医杂志,2017,45(2):136-139.
[10]邓榕,马丽华,郭靖,等.脑梗死患者早期神经功能恶化的影响因素分析[J].医学临床研究,2017,34(2):318-321.
[11]YU H,HUANG Y,CHEN X,et al.High-sensitivity C-reactive protein in stroke patients-the importance in consideration of influence of multiple factors in the predictability for disease severity and death[J].J Clin Neurosci,2017,36:12-19.
[12]裴建基.缺血性脑卒中患者发生早期神经功能恶化的相关因素分析[J].中国实用神经疾病杂志,2015,18(5):47-49.
[13]晏小琼,谭倩,余丹芳,等.急性缺血性脑卒中病人早期神经功能恶化的多因素Logistic回归分析[J].中西医结合心脑血管病杂志,2017,15(3):4641-4643.
[14]SHAMS S,MARTOLA J,GRANBERG T,et al.Cerebral microbleeds:different prevalence,topography,and risk factors depending on dementia diagnosis-the Karolinska Imaging Dementia Study[J].AJNR Am J Neuroradiol,2015,36(4):661-666.
[15]SCHNEIDER S,KORNEJEVA A,VIBO R,et al.Risk factors and etiology of young ischemic stroke patients in Estonia[J].Stroke Res Treat,2017,2017:8075697.
[16]杨国帅,周小艳,周治平,等.亚低温对大动脉闭塞性脑卒中动脉溶栓后早期神经功能恶化的影响[J].实用医学杂志,2014,30(15):2414-2416.
[17]纪法敬.急性脑梗死患者神经功能恶化原因分析及对策研究[J].现代中西医结合杂志,2013,22(13):1423-1425.
[18]周芬芬.缺血性脑卒中发生早期神经功能恶化(END)的相关因素分析[J].中国实用神经疾病杂志,2015,18(3):20-22.
[19]王庄,邱彩霞,晏玉奎.急性脑梗死患者早期神经功能恶化与阿司匹林抵抗的关系[J].预防医学,2017,29(1):70-72.
[20]王启章,李晶,刘勇,等.早期进展性脑梗死的危险因素分析[J].山东医药,2016,56(27):47-49.
[21]ALAWNEH J A,MOUSTAFA R R,BARON J C.Hemodynamic factors and perfusion abnormalities in early neurological deterioration[J].Stroke,2009,40(6):e443-e450.
[22]候红梅.急性缺血性脑卒中早期神经功能恶化的危险因素及护理研究[J].心理医生,2016,22(20):227-228.
[23]ROQUER J,RODRIGUEZ-CAMPELLO A,GOMIS M,et al.A-cute stroke unit care and early neurological deterioration in ischemic stroke[J].J Neurol,2008,255(7):1012-1017.
[24]KUMARI R,WILLING L B,PATEL S D,et al.Increased cerebral matrix metalloprotease-9activity is associated with compromised recovery in the diabetic db/db mouse following a stroke[J].J Neurochem,2011,119(5):1029-1040.
[25]孙慧英,李涛.脑卒中及其危险因素分析[J].卒中与神经疾病杂志,2012,19(3):167-170.
[26]陈文勇.缺血性脑卒中患者早期神经功能恶化的相关危险因素分析[J].中国当代医药,2015,22(25):51-53.
[27]黄红,周燕,李惠仙,等.老年高血压患者血压晨峰与颈动脉粥样硬化及缺血性脑卒中发病的相关性[J].中国老年学杂志,2012,32(22):4885-4887.
[28]李艳,梁直厚.C反应蛋白在缺血性卒中病情以及预后评估中的价值[J].中风与神经疾病杂志,2016,33(2):150-153.
[29]KIM J M,MOON J,AHN S W,et al.The etiologies of early neurological deterioration after thrombolysis and risk factors of ischemia progression[J].J Stroke Cerebrovasc Dis,2016,25(2):383-388.
[30]周行.血清超敏C-反应蛋白及同型半胱氨酸在缺血性进展型脑卒中的诊断意义[J].中国实验诊断学,2013,17(5):960.
[31]黄晓春.超敏C反应蛋白检测在缺血性脑卒中诊治中的价值[J].中国临床新医学,2014,7(3):231-233.
[32]ZHANG J,JOHNSON T R,PATEL V L,et al.Using usability heuristics to evaluate patient safety of medical devices[J].J Biomed Inform,2003,36(1/2):23-30.
[33]李海华,张丽伟.高同型半胱氨酸血症与缺血性脑卒中相关性的研究进展[J].重庆医学,2012,41(5):500-502.
[34]KWON H M,LEE Y S,BAE H J,et al.Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke[J].Stroke,2014,45(3):871-873.
[35]陈靖,殷宇慧,王劭恒.影响急性缺血性脑卒中患者病情恶化的危险因素分析[J].重庆医学,2014,43(19):2420-2422;2425.
[36]YI X,WANG C,LIU P,et al.Antiplatelet drug resistance is associated with early neurological deterioration in acute minor ischemic stroke in the Chinese population[J].J Neurol,2016,263(8):1612-1619.
[37]KANAMARU T,SUDA S,MURAGA K,et al.Albuminuria predicts early neurological deterioration in patients with acute ischemic stroke[J].J Neurol Sci,2017,372:417-420.
[2]ALVAREZ-SABIN J,MAISTERRA O,SANTAMARINA E,et al.Factors influencing haemorrhagic transformation in ischaemic stroke[J].Lancet Neurol,2013,12(7):689-705.
[3]靳贵生,李伟,张建斌.缺血性脑卒中早期神经功能恶化的影响因素及参麦注射液对其疗效的研究[J].中华神经医学杂志,2013,12(9):914-918.
[4]SENERS P,TURC G,OPPENHEIM C,et al.Incidence,causes and predictors of neurological deterioration occurring within 24h following acute ischaemic stroke:a systematic review with pathophysiological implications[J].J Neurol Neurosurg Psychiatry,2015,86(1):87-94.
[5]杨吉军,谢礼,桂培根,等.房颤对急性缺血性脑卒中严重程度和早期死亡的影响[J].中南医学科学杂志,2017,45(3):263-265.
[6]童宁.动态血压与缺血性脑卒中早期神经功能恶化的关系[J].中国实用神经疾病杂志,2016,19(8):7-9.
[7]LEE S J,HONG J M,LEE S E,et al.Association of fibrinogen level with early neurological deterioration among acute ischemic stroke patients with diabetes[J].BMC Neurol,2017,17(1):101.
[8]SIEGLER J E,BOEHME A K,KUMAR A D,et al.What change in the National Institutes of Health Stroke Scale should define neurologic deterioration in acute ischemic stroke?[J].J Stroke Cerebrovasc Dis,2013,22(5):675-682.
[9]李瑞英,陈会生.急性缺血性脑卒中早期神经功能恶化研究现状及进展[J].临床军医杂志,2017,45(2):136-139.
[10]邓榕,马丽华,郭靖,等.脑梗死患者早期神经功能恶化的影响因素分析[J].医学临床研究,2017,34(2):318-321.
[11]YU H,HUANG Y,CHEN X,et al.High-sensitivity C-reactive protein in stroke patients-the importance in consideration of influence of multiple factors in the predictability for disease severity and death[J].J Clin Neurosci,2017,36:12-19.
[12]裴建基.缺血性脑卒中患者发生早期神经功能恶化的相关因素分析[J].中国实用神经疾病杂志,2015,18(5):47-49.
[13]晏小琼,谭倩,余丹芳,等.急性缺血性脑卒中病人早期神经功能恶化的多因素Logistic回归分析[J].中西医结合心脑血管病杂志,2017,15(3):4641-4643.
[14]SHAMS S,MARTOLA J,GRANBERG T,et al.Cerebral microbleeds:different prevalence,topography,and risk factors depending on dementia diagnosis-the Karolinska Imaging Dementia Study[J].AJNR Am J Neuroradiol,2015,36(4):661-666.
[15]SCHNEIDER S,KORNEJEVA A,VIBO R,et al.Risk factors and etiology of young ischemic stroke patients in Estonia[J].Stroke Res Treat,2017,2017:8075697.
[16]杨国帅,周小艳,周治平,等.亚低温对大动脉闭塞性脑卒中动脉溶栓后早期神经功能恶化的影响[J].实用医学杂志,2014,30(15):2414-2416.
[17]纪法敬.急性脑梗死患者神经功能恶化原因分析及对策研究[J].现代中西医结合杂志,2013,22(13):1423-1425.
[18]周芬芬.缺血性脑卒中发生早期神经功能恶化(END)的相关因素分析[J].中国实用神经疾病杂志,2015,18(3):20-22.
[19]王庄,邱彩霞,晏玉奎.急性脑梗死患者早期神经功能恶化与阿司匹林抵抗的关系[J].预防医学,2017,29(1):70-72.
[20]王启章,李晶,刘勇,等.早期进展性脑梗死的危险因素分析[J].山东医药,2016,56(27):47-49.
[21]ALAWNEH J A,MOUSTAFA R R,BARON J C.Hemodynamic factors and perfusion abnormalities in early neurological deterioration[J].Stroke,2009,40(6):e443-e450.
[22]候红梅.急性缺血性脑卒中早期神经功能恶化的危险因素及护理研究[J].心理医生,2016,22(20):227-228.
[23]ROQUER J,RODRIGUEZ-CAMPELLO A,GOMIS M,et al.A-cute stroke unit care and early neurological deterioration in ischemic stroke[J].J Neurol,2008,255(7):1012-1017.
[24]KUMARI R,WILLING L B,PATEL S D,et al.Increased cerebral matrix metalloprotease-9activity is associated with compromised recovery in the diabetic db/db mouse following a stroke[J].J Neurochem,2011,119(5):1029-1040.
[25]孙慧英,李涛.脑卒中及其危险因素分析[J].卒中与神经疾病杂志,2012,19(3):167-170.
[26]陈文勇.缺血性脑卒中患者早期神经功能恶化的相关危险因素分析[J].中国当代医药,2015,22(25):51-53.
[27]黄红,周燕,李惠仙,等.老年高血压患者血压晨峰与颈动脉粥样硬化及缺血性脑卒中发病的相关性[J].中国老年学杂志,2012,32(22):4885-4887.
[28]李艳,梁直厚.C反应蛋白在缺血性卒中病情以及预后评估中的价值[J].中风与神经疾病杂志,2016,33(2):150-153.
[29]KIM J M,MOON J,AHN S W,et al.The etiologies of early neurological deterioration after thrombolysis and risk factors of ischemia progression[J].J Stroke Cerebrovasc Dis,2016,25(2):383-388.
[30]周行.血清超敏C-反应蛋白及同型半胱氨酸在缺血性进展型脑卒中的诊断意义[J].中国实验诊断学,2013,17(5):960.
[31]黄晓春.超敏C反应蛋白检测在缺血性脑卒中诊治中的价值[J].中国临床新医学,2014,7(3):231-233.
[32]ZHANG J,JOHNSON T R,PATEL V L,et al.Using usability heuristics to evaluate patient safety of medical devices[J].J Biomed Inform,2003,36(1/2):23-30.
[33]李海华,张丽伟.高同型半胱氨酸血症与缺血性脑卒中相关性的研究进展[J].重庆医学,2012,41(5):500-502.
[34]KWON H M,LEE Y S,BAE H J,et al.Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke[J].Stroke,2014,45(3):871-873.
[35]陈靖,殷宇慧,王劭恒.影响急性缺血性脑卒中患者病情恶化的危险因素分析[J].重庆医学,2014,43(19):2420-2422;2425.
[36]YI X,WANG C,LIU P,et al.Antiplatelet drug resistance is associated with early neurological deterioration in acute minor ischemic stroke in the Chinese population[J].J Neurol,2016,263(8):1612-1619.
[37]KANAMARU T,SUDA S,MURAGA K,et al.Albuminuria predicts early neurological deterioration in patients with acute ischemic stroke[J].J Neurol Sci,2017,372:417-420.