中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
10期
910-914
,共5页
李方睿%包成月%黄泽宇%国钰梅%杨丽荣%白文婷%吕利英
李方睿%包成月%黃澤宇%國鈺梅%楊麗榮%白文婷%呂利英
리방예%포성월%황택우%국옥매%양려영%백문정%려리영
复发%急性缺血性脑卒中%结局不良%残疾
複髮%急性缺血性腦卒中%結跼不良%殘疾
복발%급성결혈성뇌졸중%결국불량%잔질
Recurrence%Acute ischemic stroke%Poor outcome%Disability
目的 探讨复发对急性缺血性脑卒中患者出院结局不良的影响.方法 采用回归性队列研究方法,连续性纳入2009年6月1日到2012年5月31日内蒙古兴安盟人民医院神经内科的全部急性缺血性脑卒中患者作为研究对象,共计3 440例,结局不良定义为出院发生残疾或住院期间死亡.残疾的定义参照脑卒中量表(MRs),评分在MRs≥3定义为残疾.危险因素的分析采用两分类非条件Logistic回归方法,计算比值比(OR)及95％可信区间(95％CI).结果 3 440例患者中有结局不良者359例,发生率10.44％,其中复发者为136例,占37.88％.多因素Logistic回归分析结果表明,年龄(OR=1.24,95％CI为1.09～1.41)、体温(0R=1.92,95％CI为1.43 ～ 2.57)、高血压(OR=1.73,95％CI为1.33～2.24)、高血糖(OR=1.67,95％CI为1.26～2.20)、甘油三酯(OR=0.41,95％CI为0.27～0.62)、吸烟(OR=1.37,95％CI为1.01～ 1.85)及复发(OR=1.49,95％CI为1.15～1.95)是预后不良的独立危险因素,脑卒中复发可增加急性缺血性脑卒中患者出院结局不良49％的风险.结论 复发是急性缺血性脑卒中预后不良的独立危险因素,在临床工作及脑卒中患者的健康教育中应注重二级预防,减少急性缺血性脑卒中的复发.
目的 探討複髮對急性缺血性腦卒中患者齣院結跼不良的影響.方法 採用迴歸性隊列研究方法,連續性納入2009年6月1日到2012年5月31日內矇古興安盟人民醫院神經內科的全部急性缺血性腦卒中患者作為研究對象,共計3 440例,結跼不良定義為齣院髮生殘疾或住院期間死亡.殘疾的定義參照腦卒中量錶(MRs),評分在MRs≥3定義為殘疾.危險因素的分析採用兩分類非條件Logistic迴歸方法,計算比值比(OR)及95％可信區間(95％CI).結果 3 440例患者中有結跼不良者359例,髮生率10.44％,其中複髮者為136例,佔37.88％.多因素Logistic迴歸分析結果錶明,年齡(OR=1.24,95％CI為1.09～1.41)、體溫(0R=1.92,95％CI為1.43 ～ 2.57)、高血壓(OR=1.73,95％CI為1.33～2.24)、高血糖(OR=1.67,95％CI為1.26～2.20)、甘油三酯(OR=0.41,95％CI為0.27～0.62)、吸煙(OR=1.37,95％CI為1.01～ 1.85)及複髮(OR=1.49,95％CI為1.15～1.95)是預後不良的獨立危險因素,腦卒中複髮可增加急性缺血性腦卒中患者齣院結跼不良49％的風險.結論 複髮是急性缺血性腦卒中預後不良的獨立危險因素,在臨床工作及腦卒中患者的健康教育中應註重二級預防,減少急性缺血性腦卒中的複髮.
목적 탐토복발대급성결혈성뇌졸중환자출원결국불량적영향.방법 채용회귀성대렬연구방법,련속성납입2009년6월1일도2012년5월31일내몽고흥안맹인민의원신경내과적전부급성결혈성뇌졸중환자작위연구대상,공계3 440례,결국불량정의위출원발생잔질혹주원기간사망.잔질적정의삼조뇌졸중량표(MRs),평분재MRs≥3정의위잔질.위험인소적분석채용량분류비조건Logistic회귀방법,계산비치비(OR)급95％가신구간(95％CI).결과 3 440례환자중유결국불량자359례,발생솔10.44％,기중복발자위136례,점37.88％.다인소Logistic회귀분석결과표명,년령(OR=1.24,95％CI위1.09～1.41)、체온(0R=1.92,95％CI위1.43 ～ 2.57)、고혈압(OR=1.73,95％CI위1.33～2.24)、고혈당(OR=1.67,95％CI위1.26～2.20)、감유삼지(OR=0.41,95％CI위0.27～0.62)、흡연(OR=1.37,95％CI위1.01～ 1.85)급복발(OR=1.49,95％CI위1.15～1.95)시예후불량적독립위험인소,뇌졸중복발가증가급성결혈성뇌졸중환자출원결국불량49％적풍험.결론 복발시급성결혈성뇌졸중예후불량적독립위험인소,재림상공작급뇌졸중환자적건강교육중응주중이급예방,감소급성결혈성뇌졸중적복발.
Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge.Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People's Hospital of Xinganmeng of Inner Mongoha Autonomous Region were esearch objects.Poor outcome was defined as the occurrence of disability or death at discharge.Disability was defined as the Modified Rankin ' s Scale (MRs), when MRs was 3 or more.Binary logistic regression was used to analysis the risk factors ,calculated the odds ratios(OR) and 95％ confidence interval (95％CI).Results A total of 359 (10.44％) patients occurred poor outcomes, of whom 136 (37.88％) patients occurred the recurrence of ischemic stroke.Multiple logistic regression analysis showed that age (OR=1.24,95％CI 1.09-1.41), body temperature (OR =1.92,95 ％ CI 1.43-2.57), hypertension (OR =1.73,95 ％ CI 1.33-2.24), high blood sugar (OR=1.67,95％CI 1.26-2.20) ,glycerin trilaurate(OR=0.41,95％CI0.27-0.62) ,smoking (OR =1.37,95％CI 1.01-1.85) and recmrrence(OR=1.49,95％CI 1.15-1.95) were independent risk factors of poor outcome at discharge.The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49％.Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke, we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.
