CAJ | 학술논문

目的探讨血浆纤维蛋白原(fibrinogen,Fib)水平对首次缺血性卒中后1年内卒中复发的影响.方法前瞻性收集首次急性缺血性卒中患者,至少随访1年.将患者分为复发组与未复发组,采用多变量logistic回归分析探索首次缺血性卒中患者1年内复发的危险因素；根据发病初血浆Fib水平,将患者分为高Fib组和正常Fib组,采用Kaplan-Meier生存分析法比较两组患者复发率.结果共纳入121例首次急性缺血性卒中患者,111例完成1年随访,其中30例(27.027％)复发.多变量logistic回归分析显示,血浆Fib水平高[优势比(odds ratio,OR) 13.238,95％可信区间(confidence interval,CI)1.152～152.077;P=0.038]、初次发病年龄大(OR1.321,95％ CI 1.064～1.641;P=0.012)、体质指数高(OR 1.351,95％ CI 1.001～1.823;P=0.049)、服用抗血小板药(OR 36.819,95％ CI1.890 ～717.143;P =0.017)和降血压药(OR 50.765,95％ CI3.198 ～805.878;P=0.005)依从性差是初次缺血性卒中患者短期复发的独立危险因素.Kaplan-Meier生存函数曲线显示,高Fib组卒中复发率显著性高于正常Fib组(Log-Rank检验,P=0.000).结论血浆Fib水平增高、高龄、肥胖以及服用抗血小板药和降血压药依从性差是初次缺血性卒中患者短期复发的独立危险因素.
목적 탐토혈장섬유단백원(fibrinogen,Fib)수평대수차결혈성졸중후1년내졸중복발적영향.방법 전첨성수집수차급성결혈성졸중환자,지소수방1년.장환자분위복발조여미복발조,채용다변량logistic회귀분석탐색수차결혈성졸중환자1년내복발적위험인소；근거발병초혈장Fib수평,장환자분위고Fib조화정상Fib조,채용Kaplan-Meier생존분석법비교량조환자복발솔.결과 공납입121례수차급성결혈성졸중환자,111례완성1년수방,기중30례(27.027％)복발.다변량logistic회귀분석현시,혈장Fib수평고[우세비(odds ratio,OR) 13.238,95％가신구간(confidence interval,CI)1.152～152.077;P=0.038]、초차발병년령대(OR1.321,95％ CI 1.064～1.641;P=0.012)、체질지수고(OR 1.351,95％ CI 1.001～1.823;P=0.049)、복용항혈소판약(OR 36.819,95％ CI1.890 ～717.143;P =0.017)화강혈압약(OR 50.765,95％ CI3.198 ～805.878;P=0.005)의종성차시초차결혈성졸중환자단기복발적독립위험인소.Kaplan-Meier생존함수곡선현시,고Fib조졸중복발솔현저성고우정상Fib조(Log-Rank검험,P=0.000).결론 혈장Fib수평증고、고령、비반이급복용항혈소판약화강혈압약의종성차시초차결혈성졸중환자단기복발적독립위험인소.
Objective To investigate the effect of plasma fibrinogen (Fib) level on stroke recurrence within one year of first-ever ischemic stroke.Methods The patients with first-ever acute ischemic stroke were enrolled prospectively and were followed up for at least one year.They were divided into either a recurrent group or a non-recurrent group.Multivariate logistic regression analysis was used to explore the risk factors for stroke recurrence within one year of first-ever ischemic stroke.According to the plasma Fib levels of the early onset,the patients were divided into a high Fib group and a normal Fib group.Kaplan-Meier survival analysis was used to compare the recurrence between the two groups.Results A total of 121 patients with first-ever acute ischemic stroke were enrolled,111 completed one year follow up,and 30 of them (27.027％) had recurrent stroke.Multivariatelogistic regression analysis showed that the increased plasma Fib level (odds ratio [OR] 13.238,95％ confidence interval [CI] 1.152-152.077; P=0.038),older at the first onset (OR 1.321,95％ CI1.064-1.641;P=0.012),high body mass index(OR 1.351,95％ CI 1.001-1.823; P=0.049),and poor compliance of antiplatelet drugs (OR 36.819,95％ CI 1.890-717.143; P=0.017) and antihypertensive drugs (OR 50.765,95％ CI 3.198-805.878; P =0.005) were the dependent the risk factors for stroke recurrence within one year of first-ever ischemic stroke.Kaplan-Meier survival function curves showed that the recurrence rate of stroke in the high Fib group was significantly higher than that in the normalFib group (Log-rank test,P =0.000).Conclusions The increased high plasma Fib level,advanced age,obesity,as well as poor compliance of antiplatelet drugs and antihypertensive drugs were the independent risk factors for stroke recurrence within one year of first-ever ischemic stroke.