中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2012年
11期
769-773
,共5页
姚小英%林岩%耿介立%孙亚蒙%陈莺%施国文%徐群%李焰生
姚小英%林巖%耿介立%孫亞矇%陳鶯%施國文%徐群%李燄生
요소영%림암%경개립%손아몽%진앵%시국문%서군%리염생
脑缺血%卒中%复发%危险因素
腦缺血%卒中%複髮%危險因素
뇌결혈%졸중%복발%위험인소
Brain ischemia%Stroke%Recurrence%Risk factors
目的 探讨首发缺血性卒中患者再发卒中的类型及与相关危险因素之间的关系.方法 收集2004年1月至2009年12月在我院神经科住院诊治的再发率中患者361例.患者的首发卒中类型必须为缺血性卒中,收集并记录患者的吸烟、大量饮酒、高血压、糖尿病、高脂血症、心脏病、头颅外伤、偏头痛、心血管疾病家族史及相关药物使用史.通过Logistic多因素回归分析确定与再发卒中类型和部位相关的独立危险因素.结果 361例首发缺血性卒中患者中,有321例复发卒中类型为缺血性卒中,其中前循环梗死234例,后循环梗死75例,其余12例为前后循环分水岭梗死或前后循环多发性梗死；余40例患者复发卒中类型为颅内出血.Logistic多因素回归分析显示首发卒中年龄较大(OR=1.036,95％ CI 1.006 ～1.067,P=0.02)及合并高脂血症(OR=2.253,95％ CI 1.092 ～4.647,P=0.028)为复发缺血性卒中的独立危险因素.在亚组分析中,Logistic多因素回归分析显示心房颤动史(OR =4.217,95％ CI 1.489～11.942,P=0.007)为复发梗死位于后循环的独立危险因素.结论 年龄及高脂血症是预测首发缺血性脑梗死后再发缺血性卒中的独立预测因子,这一结果有助于临床医生评估首发缺血性卒中患者再发卒中的可能类型,从而适当调整二级预防措施.
目的 探討首髮缺血性卒中患者再髮卒中的類型及與相關危險因素之間的關繫.方法 收集2004年1月至2009年12月在我院神經科住院診治的再髮率中患者361例.患者的首髮卒中類型必鬚為缺血性卒中,收集併記錄患者的吸煙、大量飲酒、高血壓、糖尿病、高脂血癥、心髒病、頭顱外傷、偏頭痛、心血管疾病傢族史及相關藥物使用史.通過Logistic多因素迴歸分析確定與再髮卒中類型和部位相關的獨立危險因素.結果 361例首髮缺血性卒中患者中,有321例複髮卒中類型為缺血性卒中,其中前循環梗死234例,後循環梗死75例,其餘12例為前後循環分水嶺梗死或前後循環多髮性梗死；餘40例患者複髮卒中類型為顱內齣血.Logistic多因素迴歸分析顯示首髮卒中年齡較大(OR=1.036,95％ CI 1.006 ～1.067,P=0.02)及閤併高脂血癥(OR=2.253,95％ CI 1.092 ～4.647,P=0.028)為複髮缺血性卒中的獨立危險因素.在亞組分析中,Logistic多因素迴歸分析顯示心房顫動史(OR =4.217,95％ CI 1.489～11.942,P=0.007)為複髮梗死位于後循環的獨立危險因素.結論 年齡及高脂血癥是預測首髮缺血性腦梗死後再髮缺血性卒中的獨立預測因子,這一結果有助于臨床醫生評估首髮缺血性卒中患者再髮卒中的可能類型,從而適噹調整二級預防措施.
목적 탐토수발결혈성졸중환자재발졸중적류형급여상관위험인소지간적관계.방법 수집2004년1월지2009년12월재아원신경과주원진치적재발솔중환자361례.환자적수발졸중류형필수위결혈성졸중,수집병기록환자적흡연、대량음주、고혈압、당뇨병、고지혈증、심장병、두로외상、편두통、심혈관질병가족사급상관약물사용사.통과Logistic다인소회귀분석학정여재발졸중류형화부위상관적독립위험인소.결과 361례수발결혈성졸중환자중,유321례복발졸중류형위결혈성졸중,기중전순배경사234례,후순배경사75례,기여12례위전후순배분수령경사혹전후순배다발성경사；여40례환자복발졸중류형위로내출혈.Logistic다인소회귀분석현시수발졸중년령교대(OR=1.036,95％ CI 1.006 ～1.067,P=0.02)급합병고지혈증(OR=2.253,95％ CI 1.092 ～4.647,P=0.028)위복발결혈성졸중적독립위험인소.재아조분석중,Logistic다인소회귀분석현시심방전동사(OR =4.217,95％ CI 1.489～11.942,P=0.007)위복발경사위우후순배적독립위험인소.결론 년령급고지혈증시예측수발결혈성뇌경사후재발결혈성졸중적독립예측인자,저일결과유조우림상의생평고수발결혈성졸중환자재발졸중적가능류형,종이괄당조정이급예방조시.
Objective To respectively analyze the patterns and possible predictors of recurrent strokes among patients with initial ischemic stroke.Methods Three hundred and sixty-one patients with recurrent strokes (acute ischemic stroke or intracerebral hemorrhage) after initial ischemic strokes were collected from Jan 2004 to Dec 2009.The data about conventional risk factors such as smoking,heavy alcohol drinking,hypertension,diabetes,hyperlipidemia,heart diseases,head trauma,migraine,family history of cardiovascular disease,and the use of preventive medications were collected and analyzed among patients with different types of recurrent strokes.Results Patients (n =361) were divided into ischemic stroke group (n =321) and hemorrhagic stroke group (n =40) according to the recurrent stroke type.The ischemic stroke group was further divided into the anterior circulation stroke subgroup (n =234),the posterior circulation stroke subgroup (n =75) and watershed cerebral infarction or multiple infarction subgroup (n =12).Multivariate logistic regression analysis revealed that older age at initial stroke onset (OR =1.036,95 ％ CI 1.006-1.067,P =0.02) and hyperlipidemia (OR =2.253,95 ％ CI 1.092-4.647,P =0.028) were both the independent risk factors for the recurrent ischemic stroke.Comparing the subgroups,multivariate logistic regression analysis showed that atrial fibrillation (OR =4.217,95％ CI 1.489-11.942,P =0.007) was the independent risk factor for the recurrent ischemic stroke in the posterior circulation territory.Conclusion Aging and hyperlipidemia are possible predictors of recurrent ischemic stroke after the initial ischemic stroke which would be useful for individualized secondary prevention of stroke.
