老年脑梗死复发与颅外颈动脉粥样硬化及其相关因素的多元Logistic回归分析及其预防措施研究  

Multivariate logistic regression analysis and preventive measures of recurrence of cerebral infarction and extracranial carotid atherosclerosis in the elderly and its correlative factor

作　　者：张振岭[1] 

机构地区：[1]德州市人民医院,山东德州253014

出　　处：《中国现代医学杂志》2014年第25期44-48,共5页China Journal of Modern Medicine

摘　　要：目的研究老年脑梗死复发（Recurrence of cerebral infarction,RCI）与颅外颈动脉粥样硬化（Extracranial carotid atherosclerosis,ECA）及其相关因素的多元Logistic回归分析及其预防措施。方法从2010年1月-2013年1月,从该院的神经内科被确诊为脑梗死的住院患者中选择439例,根据ECA斑块产生及与RCI的联系,将439例患者分成初发性脑梗死组（327例）以及复发性脑梗死组（112例）。根据年龄阶段情况,将112例RCI患者分成青中年组（年龄〈65岁,44例）以及老年组（年龄≥65岁,68例）。统计并分析不同脑梗死类型及年龄阶段患者的临床治疗资料,研究RCI与ECA及其相关因素的关系,分析RCI的预防措施。结果复发性脑梗死组发生颈动脉硬化,硬斑形成,软斑形成,有高血压,糖尿病史者所占的比例以及整体年龄,均显著高于初发性脑梗死组。老年组RCI患者的颈动脉硬化比例,硬斑形成占比,吸烟史占比,高血压史占比,糖尿病史占比,血脂异常史占比,均显著高于中青年组RCI患者,差异均有显著性（均P〈0.05）。应用Logistic回归性分析后发现,不同年龄阶段患者发生RCI的危险因素主要为颈动脉硬化、硬斑形成、高血压史以及糖尿病史。结论老年患者RCI与ECA等因素的联系紧密,对于患者应予以重点预防,从而降低RCI的复发率,值得临床关注。【Objective】To study multivariate logistic regression analysis and preventive measures of recurrence of cerebral infarction in the elderlyand extracranial carotid atherosclerosis and its correlative factor. 【Methods】From January 2010 to January 2013, in the Department of Neurology in our hospital,those who were diagnosed as cerebral infarction, in which selected 439 cases of hospitalized patients, according to ECA plaque produced and contacted with RCI, were divided into newly diagnosed patients of cerebral infarction group（327 cases） and recurrent cerebral infarction group（112 cases）. According to age cases, 112 cases were divided into RCI young adult group（age 65years, 44 cases） and the older group（aged≥65 years, 68 cases）. The relationship and clinical data of patients with cerebral infarction of different types and ages were analyzed, and the ECA with RCI＇s related factors and RCI precautions were studied. 【Results】The occurrence of recurrent cerebral infarction group of carotid atherosclerosis,hard plaque formation and soft plaque formation, hypertension, diabetes, history and the overall percentage of age were significantly higher than in early-onset cerebral infarction group. RCI proportion of carotid atherosclerosis inolder patients group, the proportion of hard plaque formation, accounting for smoking history, hypertension history accounting, history of diabetes accounting, history of dyslipidemia accountingwere significantly higher than patients in RCI young group, the differences were statistically significant（P〈0.05）. After logistic regression analysis showed that patients with risk factors for the occurrence of different ages RCI patients mainly was carotid atherosclerosis,hard plaque formation, history of hypertension and diabetes mellitus. 【Conclusion】RCI old patients and other factors were closely related with ECA, the patient should be focused on prevention, thereby reducing the recurrence rate of RCI is worthy of attention.

关 键 词：脑梗死 复发 颅外颈动脉 粥样硬化 LOGISTIC回归分析 预防措施 

分 类 号：R743.3[医药卫生—神经病学与精神病学]