症状性颈动脉狭窄患者缺血性脑卒中再发的危险因素和治疗策略  

Risk factors and managements of stroke recurrence in patients with symptomatic carotid stenoses

作　　者：陈蓓蕾 黄敏 李军[1] 李晓波 徐运[2] 徐俊 

机构地区：[1]扬州大学临床医学院神经内科,江苏扬州225001 [2]南京大学附属鼓楼医院神经内科,江苏南京210008

出　　处：《中风与神经疾病杂志》2016年第2期131-134,共4页Journal of Apoplexy and Nervous Diseases

基　　金：扬州市科技局资助项目(YZ2011102)

摘　　要：目的评估症状性颈动脉狭窄患者缺血性脑卒中再发相关的危险因素,指导临床预防和治疗策略的制定。方法随访219例症状性颈动脉狭窄患者,给予规范化内科治疗,采集患者临床数据进行多因素回归分析、Kaplan-Meier曲线、危险比和比值比(95%可信度区间)等统计分析。结果年龄(P=0.024)、吸烟(P=0.049)、未接受他汀类药物治疗(P=0.001)、SBP(P=0.001)、FBG(P=0.022)、颈动脉不稳定斑块(P<0.001)和颈动脉重度狭窄(P=0.023)与缺血性脑卒中的再发相关。结论年龄、吸烟、未接受他汀类药物治疗、SBP、FBG、颈动脉不稳定斑块和颈动脉重度狭窄是症状性颈动脉狭窄患者缺血性脑卒中再发的相关危险因素。戒烟、他汀类药物治疗、控制SBP和FBG有助于降低症状性颈动脉狭窄患者缺血性脑卒中的再发风险。Objective To identify risk factors of ischemic stroke recurrence in patients with symptomatic carotid stenosis for the purpose of preventions and clinical managements. Methods 219 patients with symptomatic carotid stenoses accepted standard medical therapy and were followed up for 6 months. Clinical data of these patients were collected to perform such statistic analyses as multiple regression analysis,Kaplan-Meier curves,risk ratio（ RR） and odds ratio（ OR）.Results Age（ P = 0. 024）,smoking（ P = 0. 049）,therapy without statin（ P = 0. 001）,SBP（ P = 0. 001）,FBG level（ P =0. 022）,unstable plaque（ P 〈0. 001） and severe stenosis（ P = 0. 023） were significant in the statistic analyses. Conclusion Age,smoking,therapy without statin,SBP,FBG level,unstable plaque and severe stenosis were related risk factors of stroke recurrence in patients with symptomatic carotid stenosis. Smoking cessation,statin therapy and control of SBP and FBG would be benefit in reducing the incidence of stroke recurrence in these patients.

关 键 词：症状性颈动脉狭窄 缺血性脑卒中再发 危险因素 不稳定斑块 

分 类 号：R743.3[医药卫生—神经病学与精神病学]