缺血性脑卒中再发相关危险因素分析  

Analysis of risk factors related to recurrent ischemic stroke

作　　者：邹积明[1] Zou Jiming(Department of Health Care,Yantaishan Hospital,Yantai 264008,China)

机构地区：[1]山东省烟台市烟台山医院保健科,264008

出　　处：《中华老年医学杂志》2020年第3期297-300,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨包括脑白质疏松(LA)在内的相关危险因素与缺血性脑卒中再发的关系。方法连续收集2010年1月至2014年12月在我院保健科、神经内科发病72 h内住院首发急性缺血性卒中患者751例,随访3年,入选患者701例,随访中再发患者124例为再发组;首发缺血性卒中患者577例为未再发组,比较分析两组患者危险因素。结果再发组患者LA程度高于未再发组(Z=-2.307,P=0.021);再发组血糖、血压、血脂控制达标率低于未再发组(均P<0.05)。Spearson相关分析与缺血性卒中再发患者呈正相关的因素为LA(r=0.451,P=0.007)、年龄(r=0.334,P=0.015)、血压(r=0.812,P=0.001)、血糖(r=0.637,P=0.002)、低密度脂蛋白胆固醇(LDL-C)(r=0.674,P=0.000)、总胆固醇(r=0.748,P=0.003)、三酰甘油(r=0.878,P=0.004)、吸烟(r=0.380,P=0.008);与脑卒中再发无明显相关的因素为性别(r=0.032,P=0.115)。二分类Logistics回归与缺血性卒中再发呈正相关因素为年龄(B=0.142,P=0.000)、血压(B=0.135,P=0.000)、LDL-C(B=1.141,P=0.001)、三酰甘油(B=0.367,P=0.036)、血糖(B=0.385,P=0.000);与缺血性卒中再发无相关的因素为LA(B=22.221,P=0.997)、总胆固醇(B=0.081,P=0.867)、吸烟(B=21.434,P=0.995)。结论年龄、高血糖、高血压、三酰甘油是缺血性卒中患者复发的独立危险因素,LA、总胆固醇、吸烟是缺血性卒中复发的混杂因素。进行积极危险因素干预治疗,对预防缺血性卒中复发有重要意义。Objective To investigate the relationship between risk factors including leukoaraiosis(LA)and recurrent ischemic stroke.Methods A total of 751 patients with first-episode acute ischemic stroke hospitalized within 72 h of onset in the Department of Health and Neurology of our hospital from January 2010 to December 2014 were consecutively selected and followed up for 3 years.Eventually,701 patients were included in the study,with 124 patients with recurrence in the recurrence group and 577 patients without recurrence in the non-recurrence group.Associated risk factors were compared and analyzed between the two groups.Results The severity of LA in the recurrence group was significantly greater than that in the non-recurrence group(Z=-2.307,P=0.021).The rates of successful control of blood glucose,blood pressure and blood lipids in the recurrence group were significantly lower than those in the non-recurrence group,(all P<0.05).Pearson correlation analysis showed that factors positively correlated with ischemic stroke recurrence were LA(r=0.451,P=0.007),age(r=0.334,P=0.015),blood pressure(r=0.812,P=0.001),blood glucose(r=0.637,P=0.002),low density lipoprotein cholesterol(LDL-C)(r=0.674,P=0.000),total cholesterol(r=0.748,P=0.003),triacylg lycerol(r=0.878,P=0.004)and smoking(r=0.380,P=0.008),and one factor not significantly correlated with ischemic stroke recurrence was gender(r=0.032,P=0.115).The binary-class logistic regression analysis showed that factors positively correlated with ischemic stroke recurrence included age(B=0.142,P=0.000),blood pressure(B=0.135,P=0.000),LDL-C(B=1.141,P=0.001),triacylg lycerol(B=0.367,P=0.036)and blood glucose(B=0.385,P=0.000);factors not significantly correlated with ischemic stroke recurrence included LA(B=22.221,P=0.997),total cholesterol(B=0.081,P=0.867)and smoking(B=21.434,P=0.995).Conclusions Age,hyperglycemia,hypertension and triacylglycerol are independent risk factors and LA,total cholesterol and smoking are confounding factors for ischemic stroke recurrence.Active interventi

关 键 词：卒中 脑缺血 复发 危险因素 

分 类 号：R74[医药卫生—神经病学与精神病学]