CAJ | 학술논문

目的研究卒中常见危险因素对女性缺血性卒中预后的影响.方法收集缺血性卒中女性患者4 442例,随访3个月和1年,分为结局不良组[改良Rankin量表评分(mRS)3 ～6分]和结局良好组(mRS 0 ～2分),比较两组人群的年龄、卒中家族史、BMI、高血压、糖尿病、高脂血症、心房颤动(房颤)、冠心病、吸烟及中重度饮酒史等卒中危险因素的差别,并采用logistic回归分析上述因素对结局的影响.结果在3个月和1年随访时,结局不良组的年龄均显著大于结局良好组[3个月随访时(71.3±11.4)岁比(65.5±11.8)岁,1年随访时(71.9±11.3)岁比(65.1 ±11.6)岁,P均＜0.001],合并糖尿病(27.0％比23.3％,26.6％比23.6％,P均＜0.05)、房颤(18.0％比6.2％,17.9％比6.3％,P均＜0.001)及冠心病(21.4％比14.4％,21.8％比14.2％,P均＜0.001)的比例显著高于结局良好组,BMI＜ 25 kg/m2的比例高于结局良好组(66.3％比62.0％,P=0.006;66.6％比61.8％,P=0.002).3个月和1年时的不良结局与女性患者的年龄(OR=1.04,95％ CI 1.03～ 1.05;OR=1.05,95％CI 1.04 ～ 1.06)、糖尿病(均为OR=1.35,95％ CI 1.15 ～ 1.58)、房颤(OR=2.91,95％CI2.33 ～3.64;0R=2.84,95％ CI2.27～3.56)相关,而1年时的不良结局还与合并冠心病(OR=1.20,95％ CI 1.00 ～ 1.43)、高脂血症(OR=0.75,95％ CI0.60～0.94)相关.结论卒中各常见危险因素对女性缺血性卒中患者的预后会产生不同影响,应积极对女性卒中患者合并的糖尿病、房颤、冠心病进行干预.
목적 연구졸중상견위험인소대녀성결혈성졸중예후적영향.방법 수집결혈성졸중녀성환자4 442례,수방3개월화1년,분위결국불량조[개량Rankin량표평분(mRS)3 ～6분]화결국량호조(mRS 0 ～2분),비교량조인군적년령、졸중가족사、BMI、고혈압、당뇨병、고지혈증、심방전동(방전)、관심병、흡연급중중도음주사등졸중위험인소적차별,병채용logistic회귀분석상술인소대결국적영향.결과 재3개월화1년수방시,결국불량조적년령균현저대우결국량호조[3개월수방시(71.3±11.4)세비(65.5±11.8)세,1년수방시(71.9±11.3)세비(65.1 ±11.6)세,P균＜0.001],합병당뇨병(27.0％비23.3％,26.6％비23.6％,P균＜0.05)、방전(18.0％비6.2％,17.9％비6.3％,P균＜0.001)급관심병(21.4％비14.4％,21.8％비14.2％,P균＜0.001)적비례현저고우결국량호조,BMI＜ 25 kg/m2적비례고우결국량호조(66.3％비62.0％,P=0.006;66.6％비61.8％,P=0.002).3개월화1년시적불량결국여녀성환자적년령(OR=1.04,95％ CI 1.03～ 1.05;OR=1.05,95％CI 1.04 ～ 1.06)、당뇨병(균위OR=1.35,95％ CI 1.15 ～ 1.58)、방전(OR=2.91,95％CI2.33 ～3.64;0R=2.84,95％ CI2.27～3.56)상관,이1년시적불량결국환여합병관심병(OR=1.20,95％ CI 1.00 ～ 1.43)、고지혈증(OR=0.75,95％ CI0.60～0.94)상관.결론 졸중각상견위험인소대녀성결혈성졸중환자적예후회산생불동영향,응적겁대녀성졸중환자합병적당뇨병、방전、관심병진행간예.
Objective To explore the risk factors and their prognostic value in Chinese female patients with ischemic stroke.Methods A total of 4 442 female patients with ischemic stroke were enrolled in the study from the Chinese National Stroke Registry System.According to the modified Rankin Scale (mRS) score,patients were divided into the group A (with good outcomes,mRS =0-2) and the group B (with bad outcomes,mRS =3-6),with the follow-up for 12 months.The risk factors were collected at month 3 and month 12,including age,family history,body mass index (BMI),hypertension,diabetes mellitus (DM),hyperlipidemia,atrial fibrillation (AF),coronary heart disease (CHD),smoking and moderate or heavy alcohol intake.The multivariate logistic regression was performed to determine the prognostic value of those risk factors.Results Patients in the group B were older than those in the group A [month 3:(71.3 ± 11.4) years oldvs (65.5±11.8) years old and month 12:(71.9±11.3) years old vs (65.1 ±11.6)years old,with both P ＜0.001].Patients in the group B were found to have higher ratio of BMI ＜25 kg/m2(66.3％ vs 62.0％,P =0.006;66.6％ vs 61.8％,P =0.002) and more likely to have the history of DM (27.0％ vs 23.3％,26.6％ vs 23.6％,respectively; both P ＜ 0.05),A F (18.0％ vs 6.2％,17.9％ vs 6.3％,respectively; both P ＜0.001) and CHD (21.4％ vs 14.4％,21.8％ vs 14.2％,respectively; both P ＜ 0.001) than those in the group A.The multivariate logistic regression analysis showed that women's age (OR =1.04,1.05,95％ CI 1.03-1.05,1.04-1.06,respectively),the histories of DM (both OR =1.35,95％ CI 1.15-1.58,respectively) and AF (OR =2.91,2.84,95％ CI 2.33-3.64,2.27-3.56,respectively) were significantly associated with the bad outcomes at month 3 and month 12.The history of CHD was associated with the bad outcomes at month 12 (OR =1.20,95％ CI 1.00-1.43),while the history of hyperlipidemia might improve the outcome at month 12 (OR =0.75,95％ CI 0.60-0.94).Conclusions The risk factors may have different prognostic value in female patients with ischemic stroke.The diagnosis and treatment for DM,AF and CHD may be helpful to improve the prognosis in Chinese female patients with ischemic stroke.