2479例缺血性脑卒中登记患者三年随访研究

发布时间：2018-06-11 12:00

本文选题：卒中 + 血小板聚集抑制剂　；参考：《中华老年心脑血管病杂志》2016年01期

【摘要】：目的探讨卒中单元缺血性脑卒中登记患者正规降压治疗,抗血小板治疗和调脂治疗对其短期与长期预后的影响。方法收集2009年1月~2010年5月在卒中单元病房住院治疗的急性缺血性脑卒中患者2479例,男1638例,女841例,其中缺血性脑卒中合并高血压1784例,分为联合降压组361例和联合降压调脂组1423例;不合并高血压695例,分为单纯抗血小板组85例和联合调脂组610例,各组分别予抗血小板和(或)调脂和(或)降压药物治疗,均随访3年。比较3个月、1年和3年后,不同治疗方案患者预后不良发生率、复发率和病死率的差异。结果随访1年时,联合降压调脂组患者病死率和预后不良率均低于联合降压组(11.95%vs 24.93%,45.89%vs58.17%,P0.01);随访1年和3年时,复发率亦低于联合降压组(12.23%vs 27.98%,14.97%vs 27.15%,P0.01)。随访3个月时,联合调脂组患者病死率低于单纯抗血小板组(7.87%vs 15.29%,P0.05);随访1年和3年时,联合调脂组患者病死率、复发率和预后不良率均低于单纯抗血小板组(P0.05,P0.01)结论联合强化调脂,长期平稳有效降压和坚持抗血小板治疗可降低缺血性脑卒中的复发率,病死率和预后不良率。
[Abstract]:Objective to investigate the effects of regular hypotensive therapy, antiplatelet therapy and lipid-regulating therapy on the short-term and long-term prognosis of patients with stroke unit ischemic stroke. Methods from January 2009 to May 2010, 2479 patients with acute ischemic stroke, including 1638 males and 841 females, were hospitalized in stroke unit ward. Among them, 1784 cases were ischemic stroke complicated with hypertension. The patients were divided into two groups: combined hypotension group (n = 361) and combined hypotension group (n = 1423), hypertension group (n = 695), simple anti-platelet group (n = 85) and combined lipid control group (n = 610). Each group was treated with antiplatelet and / or lipid-regulating and / or antihypertensive drugs, respectively. All patients were followed up for 3 years. After 3 months, 1 year and 3 years, the incidence of poor prognosis, recurrence rate and mortality of patients with different treatment regimens were compared. Results at 1 year follow-up, the mortality and poor prognosis rate in the combined hypotension and lipid lowering group were lower than those in the combined hypotension group (11.95 vs 24.933 vs 45.89 vs 58.17 vs P 0.01), and the recurrence rate in the combined hypotension group was lower than that in the combined hypotension group (12.23 vs 27.9814.97 vs 27.15P 0.01). After 3 months follow-up, the fatality rate of patients in combined lipid control group was lower than that in anti-platelet group (7.87 vs 15.29), and the fatality rate, recurrence rate and poor prognosis rate in combined lipid regulating group were lower than those in anti-platelet group (P 0.05 P 0.01). Long-term stable and effective hypotension and antiplatelet therapy can reduce the recurrence rate, mortality and poor prognosis of ischemic stroke.
【作者单位】：天津市环湖医院神经内科五病区;
【分类号】：R743.3

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