缺血性卒中的常见诱因：病例交叉研究

发布时间：2018-03-24 00:40

本文选题：缺血性卒中　切入点：诱发因素　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:探究6种常见诱因与缺血性卒中发病的相关性,以期对预防缺血性卒中提供指导。方法:连续收集2016年5月至2016年10月山西医科大学第一医院神经内科的缺血性卒中住院患者病例资料,并在发病到入院4天内进行诱因问卷调查,运用病例交叉研究比较发病前2小时危险期与发病前一天同一时间段对照期内6种潜在诱因包括暴饮暴食、生气、消极情绪、重体力活动、因惊人事件突然改变体位、喝咖啡的暴露情况;进一步明确不同性别、年龄、病因学分型诱因暴露的差异情况。结果:1.共纳入369例患者,年龄24~93岁,平均61.75±13.57岁,其中男性220例(59.6%),女性149例(40.4%);有91例患者(24.7%)仅在发病前2小时至少暴露于其中一种诱因,其OR值为6.1(95%CI:3.74~9.94);危险期暴露于因惊人事件突然改变体位的OR值为12(95%CI:2.4~59.3),重体力活动的OR值为10.7(95%CI:4.2~27.6),生气的OR值为8(95%CI:2.3~27.5),消极情绪的OR值为4.9(95%CI:2.3~10.3),暴饮暴食的OR值为2.5(95%CI:0.82~7.61),尚未发现暴露于喝咖啡者。2.不同性别、年龄之间诱因的暴露情况无统计学差异。不同病因学亚型患者诱因暴露资料显示,重体力活动是心源性栓塞诱因(OR7.0,95%CI:4.7~41.9),消极情绪是大动脉粥样硬化(OR 3.7,95%CI:1.1~12.0)、小动脉闭塞(OR 4.3,95%CI:1.1~11.8)的诱因,但各病因学亚型之间各诱因相对危险度差异均无统计学意义。结论:1.因惊人事件突然改变体位、重体力活动、生气、消极情绪时是缺血性卒中发病的诱因。在脑血管病防治工作中应重视诱因的影响。2.尚未发现暴饮暴食、喝咖啡与缺血性卒中之间有明显相关性。3.不同性别、年龄、病因学分型诱因与缺血性卒中之间的关联程度无明显差异。
[Abstract]:Objective: to explore the relationship between six common inducements and ischemic stroke. Methods: from May 2016 to October 2016, the data of hospitalized patients with ischemic stroke in Department of Neurology, the first Hospital of Shanxi Medical University, were collected. A questionnaire survey on inducement was conducted from onset to admission within 4 days. Six potential inducements, including overeating, anger, negative emotion, were compared between the risk period of 2 hours before onset and the control period in the same time period before onset of disease. Heavy physical activity, sudden change of posture due to amazing events, exposure to coffee drinking, and further determination of the differences in the causes of exposure to different sex, age, etiological typing. Results: a total of 369 patients were included, aged 241.93 years, with an average of 61.75 卤13.57 years old. Among them, 220 men (59.6%) and 149 women (40.4%) were exposed to at least one of the inducements only two hours before the onset of the disease. Its OR value is 6.1- 95 CI: 3.749.94; the OR value of sudden change of position in dangerous period is 1295 CI: 2.4% 59.3%; OR value of heavy physical activity is 10.7% 95 CI: 4.2% 27.6; OR value of angry is 8.95 CI: 2.3kW 27.55.OR value of negative emotion is 4.995% CI2.310.3, OR value of overeating is 2.595 CI0.827.61g, it has not been found that exposure to drinking and drinking. Coffee maker by sex, There was no statistical difference between age and age in the exposure of inducements. According to the data of inducement exposure in patients with different etiological subtypes, heavy physical activity was the inducement of cardiogenic embolism, and negative emotions were OR 3.7 ~ 95 CI: 1.1C: 12.0, OR 4.39 95 CI: 1.1 / 11.8), negative emotion was the inducement of large artery atherosclerosis (OR 3.7 ~ 95 CI: 1.1C: 12.0, OR 4.39 95 CI: 1.1 + 11.8). However, there was no significant difference in the relative risk of various inducements among the subtypes of etiology. Conclusion: 1. Sudden changes in posture, heavy physical activity, and anger as a result of amazing events, Negative emotion is the inducement of ischemic stroke. In the prevention and treatment of cerebrovascular disease, we should pay attention to the influence of inducement. 2. It has not been found that overeating, drinking coffee and ischemic stroke have obvious correlation .3. different sex, age, There was no significant difference between etiological classification inducement and ischemic stroke.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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