中国实用神经疾病杂志
中國實用神經疾病雜誌
중국실용신경질병잡지
CHINESE JOURNAL OF PRACTICAL NERVOUS DISEASES
2015年
8期
5-7
,共3页
魏芳%傅淑琼%余静%马青
魏芳%傅淑瓊%餘靜%馬青
위방%부숙경%여정%마청
缺血性脑卒中%二级预防%再发脑卒中%危险因素
缺血性腦卒中%二級預防%再髮腦卒中%危險因素
결혈성뇌졸중%이급예방%재발뇌졸중%위험인소
Ischemic stroke%Secondary prevention%Recurrent stroke%Risk factors
目的：探讨缺血性脑卒中患者二级预防现状，并对其再发脑卒中危险因素及干预对策进行分析，以降低再发脑卒中的发生率。方法对2012‐06—2013‐06收治的278例脑卒中患者的临床资料进行回顾性分析，其中再发性脑卒中61例为观察组，未再发性脑卒中217例为对照组，采用Logistic逐步回归分析，分析其再发脑卒中的危险因素及干预对策。结果脑卒中患者再次发生脑卒中的发病率为24.10％（67／278），相关危险因素方面，2型糖尿病病史和高血压患病率较高，均为85.61％，控制率较低，分别为49.58％、49.16％，超重肥胖和总胆固醇水平异常的阳性率也较高，控制率也较低；单因素分析结果显示，缺血性脑卒中患者发生脑卒中有统计学意义的相关危险因素包括高血压、2型糖尿病、房颤病史、总胆固醇水平异常等相关因素；本研究中多因素分析进一步表明，再发缺血性脑卒中的独立相关危险因素是总胆固醇异常（OR＝3.472）、2型糖尿病血糖未控制（OR＝2.237），高血压未控制（OR＝2.851）和房颤病史（OR＝1.945）等。结论缺血性脑卒中患者在2型糖尿病和高血压控制率低，总胆固醇升高和超重肥胖发生率较高，总胆固醇水平升高、房颤病史及血糖、血压控制欠佳与脑卒中再发显著相关。
目的：探討缺血性腦卒中患者二級預防現狀，併對其再髮腦卒中危險因素及榦預對策進行分析，以降低再髮腦卒中的髮生率。方法對2012‐06—2013‐06收治的278例腦卒中患者的臨床資料進行迴顧性分析，其中再髮性腦卒中61例為觀察組，未再髮性腦卒中217例為對照組，採用Logistic逐步迴歸分析，分析其再髮腦卒中的危險因素及榦預對策。結果腦卒中患者再次髮生腦卒中的髮病率為24.10％（67／278），相關危險因素方麵，2型糖尿病病史和高血壓患病率較高，均為85.61％，控製率較低，分彆為49.58％、49.16％，超重肥胖和總膽固醇水平異常的暘性率也較高，控製率也較低；單因素分析結果顯示，缺血性腦卒中患者髮生腦卒中有統計學意義的相關危險因素包括高血壓、2型糖尿病、房顫病史、總膽固醇水平異常等相關因素；本研究中多因素分析進一步錶明，再髮缺血性腦卒中的獨立相關危險因素是總膽固醇異常（OR＝3.472）、2型糖尿病血糖未控製（OR＝2.237），高血壓未控製（OR＝2.851）和房顫病史（OR＝1.945）等。結論缺血性腦卒中患者在2型糖尿病和高血壓控製率低，總膽固醇升高和超重肥胖髮生率較高，總膽固醇水平升高、房顫病史及血糖、血壓控製欠佳與腦卒中再髮顯著相關。
목적：탐토결혈성뇌졸중환자이급예방현상，병대기재발뇌졸중위험인소급간예대책진행분석，이강저재발뇌졸중적발생솔。방법대2012‐06—2013‐06수치적278례뇌졸중환자적림상자료진행회고성분석，기중재발성뇌졸중61례위관찰조，미재발성뇌졸중217례위대조조，채용Logistic축보회귀분석，분석기재발뇌졸중적위험인소급간예대책。결과뇌졸중환자재차발생뇌졸중적발병솔위24.10％（67／278），상관위험인소방면，2형당뇨병병사화고혈압환병솔교고，균위85.61％，공제솔교저，분별위49.58％、49.16％，초중비반화총담고순수평이상적양성솔야교고，공제솔야교저；단인소분석결과현시，결혈성뇌졸중환자발생뇌졸중유통계학의의적상관위험인소포괄고혈압、2형당뇨병、방전병사、총담고순수평이상등상관인소；본연구중다인소분석진일보표명，재발결혈성뇌졸중적독립상관위험인소시총담고순이상（OR＝3.472）、2형당뇨병혈당미공제（OR＝2.237），고혈압미공제（OR＝2.851）화방전병사（OR＝1.945）등。결론결혈성뇌졸중환자재2형당뇨병화고혈압공제솔저，총담고순승고화초중비반발생솔교고，총담고순수평승고、방전병사급혈당、혈압공제흠가여뇌졸중재발현저상관。
Objective To investigate the present situation of secondary prevention in patients with ischemic stroke ,and to analyze the risk factors in recurrent stroke and intervention strategy to reduce the incidence of recurrence. Methods 278 cases with stroke admitted to our hospital from June 2012 to June 2013 were retrospectively analyzed ,among which 61 patients with recurrent stroke consisted of observation group ,and 217 patients with non‐recurrent stroke formed the control group ,analyzing risk factors and intervention strategies of recurrent stroke by Logistic regression analysis.Results The incidence of recurrent stroke in patients with stroke was 24.10% (67/278). Type 2 diabetes and hypertension with 85.61% accounted for a signifi‐cant proportion among the risk factors of ischemic stroke ,which had low control rates of 49.58% and 49.16%. And the posi‐tive rates of overweight ,obesity and dysfunction of total cholesterol abnormal positive were higher ,with low control rate. Uni‐variate analysis showed that patients with ischemic stroke were closely associated with multiple stroke‐related factors including hypertension ,type 2 diabetes ,history of atrial fibrillation ,abnormal cholesterol. Further multiple factor analysis showed that the independent‐related risk factors of recurrent ischemic stroke contained the abnormality of total cholesterol (OR=3.472) , uncontrolled type 2 diabetes (OR= 2.237) ,uncontrolled hypertension(OR= 2.851)and history of atrial fibrillation(OR=1.945). Conclusion The control rates of type 2 diabetes and hypertension are very low in patients with ischemic stroke ,and the incidence of overweight and obesity are high ,evaluated total cholesterol ,history of atrial fibrillation and uncontrolled blood glucose and blood pressure are significantly associated with recurrent stroke.
