急性缺血性卒中的卒中亚型与其病死率的关系219例分析  

Relationship among subtypes and case-fatality rates of acute ischemic stroke

作　　者：杨雪[1] 周红卫[1] 王贵辉[1] 李明芬[1] 

机构地区：[1]宜宾市第三人民医院神经内分泌科,四川宜宾644000

出　　处：《中国民康医学》2017年第10期7-9,16,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察急性缺血性卒中的卒中亚型与其死亡率的关系。方法:根据TOAST分型,将219例脑卒中患者分为大动脉粥样硬化型、腔隙性卒中型、心源性栓塞型以及其他和不明原因型4组,其中大动脉粥样硬化型59例(26.9%),腔隙性脑卒中型125例(57.1%),心源性栓塞型31例(14.2%)和其他原因及不明原因型4例(1.8%)。分析各组发病后1个月、6个月、12个月和24个月的死亡率以及应用COX风险模型预测危险因素与生存情况之间的关系。结果:随访24个月,总病死率为19.6%。心源性栓塞型在发病1个月的病死率最高,而大动脉粥样硬化型和腔隙性脑卒中型在发病6~24个月的病死率最高。对于发病1个月的患者,吸烟史、合并肺部感染和合并高血压病是死亡的主要因素,而发病后6~24个月的患者,冠心病史、合并肺部感染和年龄是逐渐成为死亡的主要原因。结论:这些数据强调针对不同卒中类型采取相应的二级预防措施的重要性。Objective： To investigate relationship among subtypes and case-fatality rates of acute ischemic stroke. Methods：219 patients with ischemic stroke were selected and divided into largeartery atherosclerosis（ LAA） type,cardiac embolism stroke（ CES） TYPE,lacunar stroke（ LS） type or other determined and undetermined causes（ UND） type according to TOAST criteria. The fatality rates 1,6,12 and 24 months after the disease onset were analyzed,and then COX risk model was used to predict the relationship among the risk factors and the survival situations. Results： At the 24-month follow-up,the total fatality rate was 19.6%. 1 month of the disease onset,the CES group had the highest fatality rate,while the LAA and LS groups’ highest fatality rates occurred at 6-24 months after the disease onset. During the first 30 days,cigarette smoking,combined pulmonary infection and combined hypertensionwere the main factors of death,while 6-24 months,cardiovascular disease,combined pulmonary infection and age became the main reasons gradually. Conclusions： These data highlight the importance of relevant secondary prevention of the different stroke subtypes in the stroke patients.

关 键 词：缺血性脑卒中 TOAST分型 

分 类 号：R743.31[医药卫生—神经病学与精神病学]