缺血性脑卒中幸存者的相对生存率及其影响因素分析  

Relative Survival of Patients with Ischemic Stroke

作　　者：李宓儿 王菊[1] 杜旭东 朱萍[1] 张露[1] 周沐科[2] 朱彩蓉[1] LI Mi-er;WANG Ju;DU Xu-dong;ZHU Ping;ZHANG Lu;ZHOU Mu-ke;ZHU Cai-rong(Department of Epidemiology and Health Statistics,West China School of Public Health,Sichuan University,Chengdu 610041,China;Department of Neurology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西公共卫生学院流行病与卫生统计学系,成都610041 [2]四川大学华西医院神经内科,成都610044

出　　处：《四川大学学报（医学版）》2018年第4期594-598,共5页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.81673273和No.30600511)资助

摘　　要：目的估算缺血性脑卒中幸存者的相对生存率并探索相对生存率的影响因素。方法采用寿命表法和EdererⅡ法估算首发缺血性脑卒中幸存者的相对生存率;采用泊松误差结构模型,探索缺血性脑卒中幸存者相对生存率的影响因素。结果首发缺血性脑卒中幸存者1年、3年、5年、7年相对生存率分别为99%、98%、98%、99%;相比于<53岁组,53~62岁组超额死亡风险增加[相对超额死亡风险(RER)=26.975,95%CI:1.668~410.90;P=0.020 1];相比于mRS评分<3分的患者,mRS评分≥3分超额死亡风险增加(RER=14.700,95%CI:1.05~206.45;P=0.047 3);相比于体质量正常者,体质量过轻者超额死亡风险增加(RER=10.082,95%CI:2.076~48.958,P=0.004 2)。结论对于缺血性脑卒中幸存者,生存率略低于可比的一般人群,长期生存状况较好。其中,首发年龄介于53~62岁、出院后3月mRS≥3分、体质量过轻的患者超额死亡风险相对较高,建议给予这类患者更多关注。Objective To estimate the relative survival ratio of patients with ischemic stroke and its risk factors.Methods Lifetable and EdererⅡ methods were used to estimate the relative survival ratio of patients with ischemic stroke.The Poission error structure model was adopted to determine the risk factors associated with survival.Results The patients had 99%,98%,98%and 99%relative survival ratio 1 year,3 years,5 years and 7 years after stroke,respectively.The relative excess risk of death increased with age [53-62 yr.vs.53 yr.,relative excess risk（RER=26.975,95%CI：1.668-410.90,P=0.020 1],higher mRS scores（≥3 vs.3 points,RER=14.700,95%CI：1.05-206.45,P=0.047 3）,and under body mass（vs.normal body mass,RER=10.082,95%CI：2.076-48.958,P=0.004 2）.Conclusion Ischemic stroke patients have a good prognosis,with slightly lower survival rates than the matched general populations.Those who are older,under body mass,and have a higher mRS score have lower survival rates.

关 键 词：相对生存 超额死亡风险 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]