401例缺血性脑卒中患者复发危险因素分析

发布时间：2018-11-09 15:55

【摘要】：目的探讨缺血性脑卒中复发的相关危险因素,为防治提供理论依据。 方法总结分析2011年9月-2012年9月就诊于宁医大总院心脑血管病医院的宁夏地区401例缺血性脑卒中患者的临床资料（本课题纳入424例宁夏地区确诊为初发缺血性脑卒中的患者，研究纳入的患者均经住院治疗好转后出院，出院时根据患者疾病诊断及病情需要选择院外药物并要求规律用药，，在无禁忌症情况下给予阿司匹林抗血小板聚集等二级预防，随访1年，失访23例，最终获得401例患者的资料），根据1年复发情况分为复发组与未复发组，通过住院登记记录、门诊复查、1年定期复查及电话联系等方式收集、提取复发患者和未复发患者与本课题相关的临床资料，包括：性别、年龄、卒中家族史、高血压、TIA史、糖尿病、吸烟、饮酒、冠心病、房颤、颈动脉斑块形成、高同型半胱氨酸血症、高脂血症等信息，其中复发组79例，未复发组322例，对所获得的临床资料采用卡方检验和多因素Logistic回归进行统计分析。 结果单因素采用卡方检验显示性别（X2=4.246， P=0.039）、年龄（X2=11.660，P=0.001）、高血压（X2=13.813，P0.05）、糖尿病（X2=32.427，P0.05）、吸烟（X2=5.421，P=0.029）、冠心病（X2=6.964，P=0.008）、卒中家族史（X2=5.529，P=0.022）、TIA史（X2=7.019，P=0.010）、房颤（X2=6.574，P=0.019）、高同型半胱氨酸血症（X2=35.930，P0.05）、高脂血症（X2=5.530，P=0.027）、颈动脉斑块形成（X2=68.054，P0.05），结果有统计学差异，说明男性、年龄≥60岁、高血压、糖尿病、吸烟、卒中家族史、TIA史、高同型半胱氨酸血症、高脂血症、颈动脉斑块形成是复发的危险因素；多因素分析显示糖尿病、高同型半胱氨酸血症、颈动脉斑块形成的OR值(95%CI)分别为3.728(1.588-8.753),2.858(1.280-6.383),15.346(4.355-54.079)，均P0.05，说明糖尿病、高同型半胱氨酸血症、颈动脉斑块形成是缺血性脑卒中复发的独立危险因素。 结论1．通过本研究发现糖尿病、高同型半胱氨酸血症、颈动脉斑块形成是缺血性脑卒中患者复发的独立危险因素。2．男性、年龄≥60岁、高血压、吸烟、卒中家族史、冠心病、糖尿病、TIA史、房颤、高同型半胱氨酸血症、高脂血症、颈动脉斑块形成是缺血性脑卒中患者复发的危险因素。3．缺血性脑卒中复发危险因素的有效干预对控制复发有重要意义。
[Abstract]:Objective to explore the risk factors of ischemic stroke recurrence and provide theoretical basis for prevention and treatment. Methods from September 2011 to September 2012, 401 patients with ischemic stroke in Ningxia who were admitted to Yu Ning General Hospital for Cardiovascular and Cerebrovascular Diseases were analyzed. All the patients included in the study were discharged from hospital after hospitalization treatment. According to the patients' disease diagnosis and the need of the patients, the patients were required to take drugs regularly, and aspirin was given to prevent platelet aggregation and other secondary prevention under the condition of no contraindication. All patients were followed up for one year, 23 cases were lost, and 401 cases were obtained. According to the recurrence of one year, the patients were divided into two groups: recurrence group and non-recurrence group. The data were collected by means of hospitalization record, outpatient reexamination, 1 year periodic reexamination and telephone contact, etc. The clinical data of recurrent and non-recurrent patients were extracted, including sex, age, family history of stroke, hypertension, TIA history, diabetes, smoking, alcohol consumption, coronary heart disease, atrial fibrillation, carotid plaque formation. The information of hyperhomocysteinemia and hyperlipidemia were analyzed by chi-square test and multivariate Logistic regression. Results the univariate chi-square test showed sex (X2P 4.246, P0.039), age (X2P 11.660), hypertension (X2P 13.813P 0.05), diabetes mellitus (X2n 32.427P 0.05), smoking (X2P 5.421 P 0.029). Coronary heart disease (X2P 6.964), family history of stroke (X2P 5.529), TIA), atrial fibrillation (X2P 6.574n P0.019), hyperhomocysteinemia (X235.930P0.05), coronary heart disease (X2n 6.964), stroke family history (X2n 5.529P 0.022), TIA), atrial fibrillation (X 2n 6.574n P 0.019), hyperhomocysteinemia (X235.930P 0.05). Hyperlipidemia (X2 + 5. 530), carotid plaque formation (X2 + 68.054), the results showed that male, age 鈮

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