摘要
目的探讨超急性期脑梗死合并急性心肌缺血的评估及相关因素分析。方法选取2015年1月-2016年6月首都医科大学宣武医院急诊神经内科收治的超急性期脑梗死患者342例，收集患者基本资料、辅助检查结果、体格检查、发病至就诊时间等信息。由护士进行第一时间相关危险因素及相关量表评估，比较发生急性心肌缺血患者与未发生急性心肌缺血患者之间相关因素差别，并对合并急性心肌缺血的超急性期脑梗死患者行多因素Logistic回归分析。结果所有评估患者中共19例（5．6％）发生急性心肌缺血，年龄（72±10）岁。合并急性心肌缺血患者中，〉70岁患者13例（68．4％）、房颤患者5例（26．3％）、既往急性心肌梗死病史患者10例（52．6％）均显著高于无急性心肌缺血患者。合并急性心肌缺血患者随机血糖（9．6±4．5mmol／L）、甘油三酯（4．64±1．91mmol／L）、NIHSS评分（11±2）也显著高于无急性心肌缺血患者（P〈0．05）。多因素Logistic回归分析提示：年龄〉70岁、房颤、既往心肌梗死病史和随机血糖、甘油三酯、NIHSS评分增高是脑梗死超急性期发生急性心肌缺血的独立危险因素（均P〈0．05）。结论超急性期脑梗死合并急性心肌缺血受多种因素影响，其中高龄、房颤、既往有心肌梗死病史、随机血糖和血脂水平高及神经功能缺损严重可能能够较好的预测急性心肌缺血的风险。对于合并上述危险因素的超急性期脑梗死患者，应第一时间进行评估，根据病情严重程度，及时调整医疗方案，加强护理及监护力度。
Objective To investigate the risk factors of acute myocardial ischemia in Patients with hyperacute ischemic stroke and nursing assessment. Methods 342 patients with hyperacute .ischemic stroke who were admitted to the emergency department of Xuanwu Hospitai Capital Medical University between January 2015 and June 2016 were selected in this study. Cilinical information was collected, and comparisons were made between patients with acute myocardial ischemia and those without acute myocardial ischemia. Multivariable logistic regression analysis was performed for patients with acute myocardial ischemia. Results Nineteen of 342 patients （5.6%） experienced acute myocardial ischemia. Compared to the patients without acute myocardial ischemia, there were significant differences in the age, atrial fibrillation and history of myocardial infarction, the NIHSS score, random blood glucose and lipid levels （all P〈0.05）. Multivariable logistic regression analysis showed that those older than 70 years old, atrial fibrillation, history of myocardial infarction, high NIHSS score, and high random blood glucose and lipid levels were independent risk factors for acute myocardial ischemia in patients with hyperacute ischemic stroke. Conclusion Age of 70 years or older, atrial fibrillation, history of myocardial infarction, high NIHSS score, high random blood glucose and lipid levels are risk factors predicting acute myocardial ischemia in patients with hyperacute ischemic stroke. These individuals should receive close monitoring and intensive nursing.
出处
《中国急救复苏与灾害医学杂志》
2017年第9期831-834,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
北京市教委科技计划面上项目-缺血后适应对急性脑缺血伴心肌缺血患者的心脑保护作用研究（KM20150025015）
关键词
脑心综合征
超急性期脑梗死
急性心肌缺血
护理评估
Cerebrocardiac syndrome, hyperacute ischemic stroke, acute myocardial ischemia, nursing assessment
