基于CISS分型的复发性脑梗死的高危因素及其与亚型的相关性

发布时间：2018-07-18 17:06

【摘要】：目的分析基于中国缺血性脑卒中亚型(CISS)分型的脑梗死1年内复发的危险因素及其与各亚型的相关性,为临床干预提供依据。方法收集1 446例脑梗死及随访1年内复发患者,进行CISS分型,同期调查并分析各亚型中危险因素的分布状况。运用多元回归方法分析不同脑梗死亚型患者各危险因素与1年内梗死复发的独立相关性。结果1 446例患者中,其中大动脉粥样硬化(LAA)亚型741例,穿支动脉病变(PAD)亚型501例,心源性栓塞(CS)亚型119例,病因不明(UE)亚型55例,其他(OE)亚型30例。1年内梗死复发125例,其中LAA亚型61例,PAD亚型38例,CS亚型21例,UE亚型5例,OE亚型0例。多元回归分析显示,颈动脉中度狭窄、颈动脉重度狭窄与LAA亚型1年内梗死复发独立相关(OR=6.178、9.016,95%CI:2.262~11.749、3.023~15.172,P=0.012、0.004);高血压与PAD亚型1年内梗死复发独立相关(OR=1.786,95%CI:1.102~2.942,P=0.013);年龄、心房纤颤与CS亚型1年内脑梗死复发独立相关(OR=1.031、6.179,95%CI:1.012~1.051、1.045~35.128,P=0.003、0.032)。结论颈动脉中重度狭窄是LAA亚型复发的独立危险因素,高血压是PAD亚型复发的独立危险因素,年龄、心房纤颤是CS亚型复发的独立危险因素。
[Abstract]:Objective to analyze the risk factors of cerebral infarction recurrence in one year based on the type of cerebral ischemic stroke in China (CISS) and the correlation between the risk factors and the subtypes, so as to provide the basis for clinical intervention. Methods 1 446 patients with cerebral infarction and recurrence within one year were collected and classified by CISS. The distribution of risk factors in each subtype was investigated and analyzed at the same time. Multivariate regression method was used to analyze the independent correlation between the risk factors of different cerebral infarction subtypes and the recurrence of infarction within 1 year. Results among the 1 446 patients, there were 741 patients with large artery atherosclerosis (LAA), 501 with perforating artery disease (pad), 119 with cardiac embolism (CS), 55 with unknown etiology (UE), and 30 with other subtypes (OE). Among them, 61 cases of LAA subtype, 38 cases of pad subtype, 21 cases of CS subtype, 21 cases of UE subtype, 5 cases of OE subtype, 0 cases. Multiple regression analysis showed that moderate carotid stenosis and severe carotid stenosis were independently correlated with infarction recurrence within one year of LAA subtype (OR6.1789.016995 CI: 2.262v 11.749v 3.02315.172P 0.0120.004); hypertension and pad subtype had an independent correlation with infarct recurrence within one year (OR1.78695CIW 1.102Cv 2.942P0. 013); age, There was an independent correlation between atrial fibrillation and the recurrence of cerebral infarction within 1 year of CS subtype (OR 1.031 ~ 6.179 ~ 95 CI: 1.012 ~ 1.051 ~ 1.045 ~ 35.128 ~ 0.003 ~ 0.032). Conclusion moderate and severe stenosis of carotid artery is an independent risk factor for recurrence of LAA subtype, hypertension is an independent risk factor for recurrence of pad subtype, age and atrial fibrillation are independent risk factors for recurrence of CS subtype.
【作者单位】：安徽省医科大学附属安庆医院神经内科;
【基金】：安徽省卫生厅医学科研自筹项目(编号:2010C114)
【分类号】：R743.33

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