非心源性急性缺血性脑卒中患者复发缺血的相关危险因素分析  

Analysis of risk factors related to recurrent ischemia in patients with non-cardiogenic acute ischemic stroke

作　　者：吕立杨 寿旦 LYU Liyang;SHOU Dan(Department of Clinical Laboratory,The Sixth People's Hospital of Zhuji City in Zhejiang Province,Shaoxing 311800,China;Department of Neurology,The Sixth People's Hospital of Zhuji City in Zhejiang Province,Shaoxing 311800,China)

机构地区：[1]浙江省诸暨市第六人民医院检验科,绍兴311800 [2]浙江省诸暨市第六人民医院神经内科,绍兴311800

出　　处：《浙江医学教育》2024年第4期251-256,共6页Zhejiang Medical Education

摘　　要：目的分析非心源性急性缺血性脑卒中(non-cardiogenic acute ischemic stroke,NCAIS)患者复发缺血的相关危险因素,探讨这些因素在预测复发中的价值。方法选择2019年1月至2022年12月在浙江省诸暨市第六人民医院接受诊治的175例NCAIS患者为研究对象,根据随访1年的结果将其分为复发组和非复发组,复发组25例患者,非复发组150例患者。比较两组患者入组时一般资料、临床资料和随访1年内抗血小板药物、他汀类药物用药依从性。单因素分析和Logistic回归分析NCAIS复发的影响因素。结果NCAIS患者1年内缺血复发率为14.29%。复发组患者年龄≥65岁的比例、颅内动脉狭窄评分、α角和MA值均明显高于非复发组患者,而R值和K值则明显低于非复发组患者,其差异均具有统计学意义(均P<0.05)。复发组患者出院后抗血小板和他汀类药物用药依从性均明显低于非复发组患者,其差异具有统计学意义(P<0.05)。经过Logistic回归分析,年龄、颅内动脉狭窄评分、α角和MA值可以作为NCAIS复发缺血的独立危险因素,出院后抗血小板和他汀类药物用药高依从性、R值和K值延长是预防NCAIS复发缺血的保护因素(均P<0.05)。结论R值和K值延长、出院后服用抗血小板和/或他汀类药物的高依从性是预防NCAIS复发缺血的保护因素;年龄、颅内动脉狭窄评分、R值、K值、α角、MA值、用药依从性与NCAIS复发缺血相关,在预测NCAIS患者复发缺血中具有较高的价值。Objective To analyze the risk factors associated with recurrent ischemia in patients with non-cardiogenic acute ischemic stroke(NCAIS)and to explore the value of these factors in predicting recurrence.Methods A total of 175 patients with NCAIS treated at The Sixth People's Hospital of Zhuji City,Zhejiang Province during January 2019 to December 2022,were selected as the study subjects.They were divided into recurrence and non-recurrence groups based on different outcomes after a 1-year follow-up,with 25 patients in the recurrence group and 150 in the non-recurrence group.The general information,clinical data,and medication adherence to antiplatelet and statin drugs within 1 year of follow-up were compared between the two groups.Univariate analysis and Logistic regression analysis were used to identify the influencing factors for NCAIS recurrence.Results The ischemic recurrence rate within one year in NCAIS patients was 14.29%.The proportion of patients aged≥65 years,intracranial arterial stenosis scores,αangle,and MA values in the recurrence group were significantly higher than those in the non-recurrence group,while the R value and K value were significantly lower,with all differences being statistically significant(all P<0.05).The medication adherence to antiplatelet and statin drugs after discharge in the recurrence group was significantly lower than that in the non-recurrence group,and the difference was statistically significant(P<0.05).After Logistic regression analysis,age,intracranial arterial stenosis score,αangle,and MA value,as well as medication adherence,were identified as independent risk factors for NCAIS ischemia recurrence;prolonged R and K values,and high adherence to antiplatelet and/or statin medication after discharge,were protective factors in preventing NCAIS recurrence(all P<0.05).Conclusions Age,intracranial arterial stenosis score,R value,K value,αangle,MA value,and medication adherence are related to NCAIS recurrence.These factors have high clinical value in predicting recurrent is

关 键 词：非心源性急性缺血性脑卒中 复发缺血 危险因素 

分 类 号：R743.32[医药卫生—神经病学与精神病学]