脑梗死长期复发的部位研究

发布时间：2018-12-12 20:24

【摘要】：目的:研究脑梗死长期复发的部位是否在同一脑循环系统。方法:回顾性研究了北京大学人民医院神经内科3年内全部有头颅磁共振证实初次脑梗死的住院患者,电话随访和电子病历相结合确定其为5年内单发或复发。对复发的病例录入基本资料和影像学资料,并将复发病例按复发部位是否在同一脑循环系统分为两组,应用Logistics回归筛选各个变量是否为复发部位在同一脑循环系统的独立危险因素。结果:复发组106例,5年内在同一脑循环系统总复发比率为46.2%,在不同系统总复发比率为53.8%,Logistic回归筛选发现复发部位是否在同一脑循环系统与年龄、性别、高血压、糖尿病、吸烟等无相关性,而与生存时间(复发时间)相关,复发时间越短越倾向于在相同脑循环系统复发,而复发时间越长,越倾向于在不同脑循环系统复发。并且第1年复发总例数最多,占5年内复发总数的37%。结论:通过对脑梗死5年内复发的部位进行研究,发现越是长期复发,部位越倾向于在不同脑循环系统,从而强调了长期药物治疗的重要性,但是在短期,尤其1年内,相同脑循环系统复发的几率较大(60.0%),从而证明了大动脉粥样硬化性脑梗死早期1年内给予血管内治疗的合理性。
[Abstract]:Objective: to study whether the long-term recurrence of cerebral infarction is in the same circulatory system. Methods: all the inpatients with primary cerebral infarction confirmed by cranial magnetic resonance within 3 years were studied retrospectively. The patients were confirmed as single or recurrent within 5 years by telephone follow-up and electronic medical records. The recrudescent cases were inputted into basic data and imaging data, and the recurrent cases were divided into two groups according to whether the recurrence site was in the same cerebral circulatory system or not. Logistics regression was used to screen each variable as an independent risk factor for recurrence in the same circulatory system. Results: the total recurrence rate in the same cerebral circulatory system was 46.2 in 5 years in 106 patients with recurrence. Logistic regression analysis showed that the recurrence site was in the same cerebral circulatory system, age and sex, and the recurrence rate was 53.8% in different systems. There was no correlation among hypertension, diabetes and smoking, but there was no correlation with survival time (recurrence time). The shorter the recurrence time, the more prone to recurrence in the same cerebral circulatory system, and the longer the recurrence time, the more prone to relapse in different cerebral circulatory system. The total number of recurrence in the first year was the highest, accounting for 37% of the total recurrence in 5 years. Conclusion: through the study of the recurrence sites in 5 years of cerebral infarction, we found that the more long-term recurrence, the more prone to different cerebral circulatory system, thus emphasizing the importance of long-term drug treatment, but in the short term, especially within one year, The recurrence rate of the same cerebral circulatory system was higher (60.0%), which proved the rationality of intravascular treatment in the early stage of atherosclerotic cerebral infarction.
【作者单位】：北京大学人民医院神经内科;
【基金】：国家自然科学基金项目(编号:81441040)
【分类号】：R743.3

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