海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
8期
1102-1104
,共3页
脑梗死%复发%危险因素%COX回归模型
腦梗死%複髮%危險因素%COX迴歸模型
뇌경사%복발%위험인소%COX회귀모형
Cerebral infarction%Recurrence%Risk factors%COX regression model
目的：探讨复发性脑梗死患者的相关危险因素，构建脑梗死复发的预测模型。方法回顾性分析2008年1月1日至2011年12月31日确诊的初发性脑梗死(First Cerebral Infarction，FCI)患者的病历信息资料，并对患者的复发情况进行追踪随访；运用Kaplan-Meier法计算患者的复发率，描绘患者的无复发生存曲线；采用多因素Cox回归分析筛选影响患者复发的独立危险因素，并建立患者复发预测模型。结果共纳入符合条件的脑梗死患者367例，随访1~54个月，中位随访时间22个月。随访期间74例（20.2%）患者复发，无复发生存时间1~32个月，1年、2年、3年累积无复发生存率分别为80.0%、66.3%、52.0%。多因素Cox比例风险回归模型分析发现，年龄≥60岁、高血压病史、糖尿病史、冠心病史、总胆固醇≥5.17 mmoL/L是脑梗死患者复发的独立危险因素(P<0.05)。脑梗死患者复发风险函数模型表达式为：h(t)=h0exp (2.559X1+1.978X2+1.901X2+1.331X4+1.719X5)。结论脑梗死复发是多因素影响的结果，年龄≥60岁、高血压病史、糖尿病史、冠心病史、总胆固醇≥5.17 mmoL/L是主要危险因素。针对可控因素进行干预和治疗是预防脑梗死复发的重要途径之一。
目的：探討複髮性腦梗死患者的相關危險因素，構建腦梗死複髮的預測模型。方法迴顧性分析2008年1月1日至2011年12月31日確診的初髮性腦梗死(First Cerebral Infarction，FCI)患者的病歷信息資料，併對患者的複髮情況進行追蹤隨訪；運用Kaplan-Meier法計算患者的複髮率，描繪患者的無複髮生存麯線；採用多因素Cox迴歸分析篩選影響患者複髮的獨立危險因素，併建立患者複髮預測模型。結果共納入符閤條件的腦梗死患者367例，隨訪1~54箇月，中位隨訪時間22箇月。隨訪期間74例（20.2%）患者複髮，無複髮生存時間1~32箇月，1年、2年、3年纍積無複髮生存率分彆為80.0%、66.3%、52.0%。多因素Cox比例風險迴歸模型分析髮現，年齡≥60歲、高血壓病史、糖尿病史、冠心病史、總膽固醇≥5.17 mmoL/L是腦梗死患者複髮的獨立危險因素(P<0.05)。腦梗死患者複髮風險函數模型錶達式為：h(t)=h0exp (2.559X1+1.978X2+1.901X2+1.331X4+1.719X5)。結論腦梗死複髮是多因素影響的結果，年齡≥60歲、高血壓病史、糖尿病史、冠心病史、總膽固醇≥5.17 mmoL/L是主要危險因素。針對可控因素進行榦預和治療是預防腦梗死複髮的重要途徑之一。
목적：탐토복발성뇌경사환자적상관위험인소，구건뇌경사복발적예측모형。방법회고성분석2008년1월1일지2011년12월31일학진적초발성뇌경사(First Cerebral Infarction，FCI)환자적병력신식자료，병대환자적복발정황진행추종수방；운용Kaplan-Meier법계산환자적복발솔，묘회환자적무복발생존곡선；채용다인소Cox회귀분석사선영향환자복발적독립위험인소，병건립환자복발예측모형。결과공납입부합조건적뇌경사환자367례，수방1~54개월，중위수방시간22개월。수방기간74례（20.2%）환자복발，무복발생존시간1~32개월，1년、2년、3년루적무복발생존솔분별위80.0%、66.3%、52.0%。다인소Cox비례풍험회귀모형분석발현，년령≥60세、고혈압병사、당뇨병사、관심병사、총담고순≥5.17 mmoL/L시뇌경사환자복발적독립위험인소(P<0.05)。뇌경사환자복발풍험함수모형표체식위：h(t)=h0exp (2.559X1+1.978X2+1.901X2+1.331X4+1.719X5)。결론뇌경사복발시다인소영향적결과，년령≥60세、고혈압병사、당뇨병사、관심병사、총담고순≥5.17 mmoL/L시주요위험인소。침대가공인소진행간예화치료시예방뇌경사복발적중요도경지일。
Objective To explore the risk factors of recurrent cerebral infarction and establish prediction model for recurrent cerebral infarction. Methods We retrospectively reviewed the charts of patients diagnosed with first cerebral infarction during the period from January 1, 2008 to December 31, 2011 and followed up the patients. Ka-plan-Meier method was used to estimate recurrence rates and to plot relapse-free survival curves of patients at differ-ent levels of predictive factors. Multivariate Cox proportional hazards model was used to select independent risk fac-tors of patients’relapse and establish prediction model for recurrent cerebral infarction. Results A total of 367 cases of cerebral infarction were included, followed up for 1 to 54 months, with a median follow-up time of 22 months. Dur-ing the follow-up, 74 patients (20.2%) relapse, with the relapse-free survival time of 1~32 months. The 1-year, 2-year, 3-year cumulative recurrence-free survival rates were 80.0%, 66.3%, 52.0%, respectively. Multivariate Cox proportion-al hazards regression analysis found that age≥60 years, history of hypertension, diabetes, coronary heart disease, to-tal cholesterol≥5.17 mmol/L were the independent risk factors for recurrence with cerebral infarction (P<0.05). The risk of recurrence in patients with cerebral infarction function model expression was. Conclusion Recurrent cerebral infarction is the result of many factors. Age≥60 years, history of hypertension, diabetes, coronary heart disease, total cholesterol≥5.17 mmol/L are the major risk factors. Intervention and treatment of the controllable factors is one of the important ways to prevent the recurrence of cerebral infarctione.
