Abstract: Objective　To explore the relationship between disease progression and vascular basis in patients with acute cerebral infarction (ACI). Methods　This was a prospective study. Sixty-two patients with progressive ACI admitted to Nanyang Second People's Hospital were enrolled as a progression group between May 2019 and October 2021, including 32 males and 30 females who were (58.69±4.61) years old. A total of 68 patients with non-progressive ACI during the same period were enrolled as a non-progression group, including 36 males and 32 females who were (57.48±5.01) years old. The blood pressure variability (BPV) was detected by the ambulatory blood pressure measuring-apparatus. The carotid artery conditions were detected by carotid ultrasound. The intima-media thickness (IMT) and scores of carotid atherosclerotic plaques (Grouse scores) were measured. The plaque index was assessed. The measurement data were compared by t test, and the count data by χ² test. The relationships of ACI progression with BPV, IMT, and Grouse score were analyzed by Spearman correlation analysis. The risk factors of progressive ACI were analyzed by multivariate logistic regression analysis. Results　The proportions of the patients with diabetes mellitus and smoking, BPV_(SBP), BPV_(DBP), proportion of the patients whose IMT ≥1.3 mm, Grouse score, and plaque index in the progression group were higher than those in the non-progression group (all P<0.05). BPV_(SBP), BPV_(DBP), IMT, Grouse score, and plaque index were positively correlated with NIHSS score (r=0.551, 0.504, 0.569, 0.711, and 0.698; all P<0.001). Diabetes mellitus, smoking, BPV_(SBP)>0.12, BPV_(DBP)>0.17, and Grouse score >5.68 were risk factors of the progression in the ACI patients (all P<0.05). Conclusions　There is a relationship between disease progression and vascular basis in ACI patients. Diabetes mellitus, smoking, BPV, and Grouse score will increase the risk of progression in patients with ACI.

Key words: Acute cerebral infarction, Disease progression, Vascular basis

摘要： 目的　探讨急性脑梗死（ACI）患者疾病进展与血管基础的关系。方法　采用前瞻性分析方法，选取南阳市第二人民医院2019年5月至2021年10月收治的进展性ACI患者62例（进展组），其中男32例、女30例，年龄（58.69±4.61）岁；选取同期非进展ACI患者68例（非进展组），其中男36例、女32例，年龄（57.48±5.01）岁。动态血压检测仪检测血压变异性（BPV）情况，颈动脉超声检测患者的颈动脉情况，测量内膜中层厚度值（IMT）、颈动脉粥样斑块积分（Grouse积分）和评估斑块指数，计量资料采用t检验，计数资料采用χ²检验，Spearman相关性分析BPV、IMT、Grouse积分与ACI疾病进展关系，多因素logistic回归分析进展性ACI疾病的危险因素。结果　进展组患者糖尿病、吸烟构成比、BPV_（SBP）、BPV_（DBP）、IMT≥1.3 mm构成比、Grouse积分、斑块指数高于非进展组（均P<0.05）。BPV_（SBP）、BPV_（DBP）、IMT、Grouse积分、斑块指数与NIHSS评分呈正相关（r=0.551、0.504、0.569、0.711、0.698，均P<0.001）。糖尿病、吸烟、BPV_（SBP）>0.12、BPV_（DBP）>0.17、Grouse积分>5.68分是ACI患者疾病进展的危险因素（均P<0.05）。结论　ACI患者疾病进展与患者自身血管基础情况存在关系，且合并糖尿病、吸烟、BPV以及Grouse积分会增加ACI疾病进展风险。

关键词: 急性脑梗死, 疾病进展, 血管基础