影响大动脉粥样硬化性脑梗死复发的危险因素

发布时间：2018-04-19 09:01

本文选题：脑梗死 + 卒中复发　；参考：《南方医科大学学报》2017年12期

【摘要】：目的研究首发大动脉粥样硬化性脑梗死患者复发的危险因素。方法连续入组在神经内科就诊的首发缺血性卒中患者,并经CTA或MRA证实为大动脉粥样硬化性脑梗死。所有入组患者进行1年随访,根据随访期间是否复发脑梗死分为缺血性卒中复发组和非复发组,比较两组患者的临床资料,并通过单因素方差分析、Cox回归模型确定复发性缺血性卒中的独立预测因素。结果 256例符合纳入标准,全部病例完成随访,30例(11.7%)随访期间发生缺血性脑血管事件。单因素方差分析显示,复发组与非复发组在饮酒习惯(P=0.028)、吸烟(P=0.007)、高密度脂蛋白胆固醇(P=0.045)、缺血性心脏病(P=0.002)、抗高血压药物(P=0.036)和他汀类药物(P=0.016)使用方面的差异有统计学意义。Cox回归分析显示不规则使用他汀类药物(HR=0.410,P=0.043)、吸烟(HR=2.253,P=0.043)、高密度脂蛋白胆固醇(HR=0.327,P=0.029)、缺血性心脏病(HR=8.566,P0.001)与缺血性脑卒中复发相关。结论不规则使用他汀类药物、低高密度脂蛋白水平、吸烟和既往有冠心病患者缺血性卒中复发风险较高。
[Abstract]:Objective to study the risk factors of recurrence in patients with primary atherosclerotic cerebral infarction.Methods the first ischemic stroke patients who were admitted to the department of neurology were confirmed as atherosclerotic cerebral infarction by CTA or MRA.All the patients were followed up for one year. According to whether the recurrent cerebral infarction occurred during the follow-up period, the patients were divided into recurrent ischemic stroke group and non-recurrence group. The clinical data of the two groups were compared.The independent predictors of recurrent ischemic stroke were determined by univariate ANOVA Cox regression model.Results 256 cases met the inclusion criteria, and 30 cases with ischemic cerebrovascular events occurred during the follow-up.Single factor analysis of variance showed thatThere were significant differences between recurrent and non-recurrent groups in the use of alcohol consumption, smoking, high density lipoprotein cholesterol, ischemic heart disease, antihypertensive drug P0. 036) and statins (P0. 016). Cox regression analysis showed that there was no rule in the use of P0. 028, P0. 007, HDL-C, P0. 002, P0. 036) and statin (P0. 016).The recurrence of ischemic stroke was associated with the use of statin (0.410), smoking (2.253), high density lipoprotein cholesterol (HR-0.327) and ischemic heart disease (HR8.566p _ (0.001)).Conclusion irregular use of statins, low density lipoprotein levels, smoking and coronary heart disease patients with ischemic stroke risk is higher.
【作者单位】：南方医科大学;广东省第二人民医院神经内科;广州医科大学附属深圳沙井医院;
【基金】：广州市科技计划项目(201707010436) 广东省中医药局科研项目(20173024) 广东省第二人民医院引进人才科研启动基金(YY2016-005) 深圳市科技计划项目(JCYJ20150402095058880)
【分类号】：R743.33

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