基于医院信息管理系统对中风病患者复中因素的研究

发布时间：2019-02-20 09:39

【摘要】：目的:探讨导致中风病患者复发的危险因素及其程度的研究。方法:采用前瞻性,多中心,大样本,通过HIS(医院信息管理系统)筛选出2014年01月01日—2015年12月31日年所有中风病患者的信息,根据既往中风病史信息及入院诊断分成中风复发与中风未复发2类。通过分析患者基本信息、既往史、家族史、吸烟、饮酒、理化检查、诊断等,分析中风病复发的危险因素及其影响复发的程度。结果:中风病复中年龄主要在44-84岁之间,占78.28%。其中54-64岁发病率最高,占30.11%;64-74岁发病率次之,占26.57%;74-84岁发病率居第三位,占21.60%;P0.05。中风复中的1780例患者中,男性患者1037例,占65.38%,女性743例,占42.80%,P0.05。中风复中中大学及以上学历患者占13.54%;而中学以下学历患者占86.46%,P0.05。中风复中患者中合并既往高血压患者比例53.7%高于新发中风病患者合并既往高血压41.76%。合并既往糖尿病的中风复中22.01高于新发中风12.45%,P0.05。经常饮酒者占21.57%,高于新发中风比例,说明经常饮酒是中风复中的危险因素,P0.05。素食为主者中中风复中略高于中风新发,P0.05。证候中风痰阻络型的发病率最高,占38.46%;气虚血瘀型次之,占16.07%,P0.05。单因素Logistic回归:研究中风病复发的危险因素与年龄、性别、文化程度、既往高血压病史、既往糖尿病病史、经常饮酒、素食为主、证候等因素与新发中风相比有统计学差异(P0.05)。广义Boosted模型:研究结果显示前6位影响程度最大的变量:家族冠心病史;家庭关怀;证候;既往高血压病史;体重;既往糖尿病史。结论:中风病复中因素的研究对指导临床有重要意义。一方面利于中风病患者的二级预防;另一方面利于指导医生的临床诊疗,进而避免中风病的再次发作。
[Abstract]:Objective: to investigate the risk factors and degree of recurrence of stroke patients. Methods: all stroke patients from January 01, 2014 to December 31, 2015 were screened by HIS (Hospital Information Management system) using a prospective, multicenter, large sample. According to the past history of stroke and admission diagnosis, there were two types of recurrent stroke and no recurrence of stroke. By analyzing patients' basic information, past history, family history, smoking, drinking, physical and chemical examination, diagnosis and so on, the risk factors of stroke recurrence and the extent of its influence on recurrence were analyzed. Results: the middle age of apoplexy was between 44 and 84 years old (78.28%). The incidence rate of 54-64 years old was the highest, accounting for 30.11% 64-74 years old, followed by 26.57% 74-84 years old incidence rate, accounting for 21.60% (P 0.05). Of the 1780 stroke patients, 1037 were males (65.38%), 743 females (42.80%). The proportion of stroke patients with secondary school education and above was 13.54, while that of patients with lower secondary school education was 86.46% (P0.05). 53.7% of stroke patients with past hypertension were higher than new stroke patients with past hypertension 41.76%. The incidence of stroke in patients with diabetes mellitus was 22.01 higher than that in newly diagnosed stroke patients (P 0.05). Regular drinkers accounted for 21.57, higher than the proportion of new strokes, indicating that regular drinking is a risk factor in stroke recovery, P0.05. The main vegetarians were slightly higher in stroke recovery than in new apoplexy (P0. 05. 0. 05). Syndrome apoplexy phlegm blocking collaterals the highest incidence of 38.46, Qi deficiency and blood stasis type followed, accounting for 16.07G P0.05. Univariate Logistic regression: risk factors and age, sex, education, history of hypertension, history of diabetes, frequent drinking, vegetarianism were studied. Syndromes and other factors and new stroke compared with statistical differences (P0.05). Generalized Boosted model: the first six most influential variables were: family history of coronary heart disease; family care; syndromes; history of hypertension; weight; history of diabetes mellitus. Conclusion: the study on the factors of stroke resuscitation is of great significance in guiding clinical practice. On the one hand, it is beneficial to the secondary prevention of apoplexy; on the other hand, it is helpful to guide the doctor's clinical diagnosis and treatment, and to avoid the recurrence of apoplexy.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R255.2

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