长沙市社区腔隙性脑梗死的预后研究

发布时间：2018-03-02 13:13

本文选题：腔隙性脑梗死　切入点：预后　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：收集2006-2012年长沙市社区新发缺血性卒中(Ischemic stroke)患者发病、复发及死亡资料,通过比较腔隙性脑梗死(lacunar infarction LAC)与非腔隙性脑梗死(非LAC)患者结局事件差异,评估LAC患者预后,并分析影响其预后的危险因素。方法：利用长沙市天心区坡子街社区和裕南街社区建立的脑卒中疾病监测网络体系对2006-2012年两社区新发缺血性卒中患者进行卒中登记,采用前瞻性研究方法对登记的卒中患者进行随访调查,收集其复发及死亡等预后资料,采用Kaplan-Meier法描绘LAC患者生存曲线,COX比例风险回归模型进行LAC预后影响因素的分析。结果：2006-2012年研究社区共登记新发缺血性卒中患者790人,其中LAC278人,非LAC512人,经1-7年的随访监测,死亡228人,复发脑卒中113人。在调整年龄、性别、高血压、高血脂、糖尿病、吸烟等基线危险因素后,LAC患者和非LAC患者在死亡率和卒中复发率上无明显差异；调整危险因素后发现,年龄、男性、高血压、糖尿病是LAC患者死亡事件的独立危险因素,年龄、糖尿病是LAC患者复发卒中的独立危险因素。结论:LAC远期预后与非LAC差别不大；年龄、男性、高血压、糖尿病是LAC患者死亡事件的独立危险因素,年龄、糖尿病是LAC患者复发卒中的独立危险因素,积极有效的控制高血压和糖尿病可能可以改善LAC患者的预后。
[Abstract]:Objective: to collect the data of onset, recurrence and death of newly diagnosed ischemic stroke patients in Changsha from 2006 to 2012, and to evaluate the prognosis of patients with LAC by comparing the outcome events between lacunar and non-lacunar cerebral infarction (lacunar) patients and non-lacunar cerebral infarction (non-lacunar cerebral infarction) patients. The risk factors influencing the prognosis were analyzed. Methods: the stroke disease surveillance network system was established in Puzi Street Community and Yu Nan Street Community, Tianxin District, Changsha City. Stroke registration was carried out between 2006 and 2012 in the two communities. A prospective study was conducted to investigate the recurrence and mortality of patients with stroke. The survival curve of patients with LAC was described by Kaplan-Meier method and Cox proportional risk regression model was used to analyze the prognostic factors of LAC. Results A total of 790 new ischemic stroke patients were registered in the study community from 2006 to 2012, including LAC278 and non-#en1#. After 1-7 years of follow-up, 228 patients died and 113 had recurrent stroke. Age, sex, hypertension, hyperlipidemia, diabetes mellitus were adjusted for age, sex, hypertension, hyperlipidemia, diabetes mellitus. After smoking and other baseline risk factors, there was no significant difference in mortality and stroke recurrence rate between patients with LAC and non-patients with LAC. After adjusting for risk factors, age, male, hypertension and diabetes were independent risk factors of death events in LAC patients. Diabetes is an independent risk factor for recurrent stroke in patients with LAC. Conclusion there is no significant difference between the long term prognosis of LAC and that of non LAC. Age, male, hypertension and diabetes are independent risk factors of death events in LAC patients. Age and diabetes are independent risk factors for recurrent stroke in LAC patients. Active and effective control of hypertension and diabetes may improve the prognosis of patients with LAC.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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