《中国康复理论与实践》

《中国康复理论与实践》

• 临床研究 • 上一篇    下一篇

复发性缺血性脑卒中的危险因素、严重程度及短期预后分析①

田婷1，关智媛2，石正洪1，栗静1，冯斌1   

  1. 1.兰州大学第二医院神经内科临床医学中心，甘肃兰州市730000；2.兰州大学第二临床医学院，甘肃兰州市730000。
  • 出版日期:2016-02-25 发布日期:2016-06-01

Risk Factors, Severity and Short-term Outcome of Recurrent Ischemic Stroke

TIAN Ting1, GUAN Zhi-yuan2, SHI Zheng-hong1, LI Jing1, FENG Bin1   

  1. 1. Clinical Medicine Center of Neurology Department, the Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China; 2. The Second School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
  • Published:2016-02-25 Online:2016-06-01

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摘要： 目的探讨复发性缺血性脑卒中的危险因素，评价其严重程度及短期预后。方法2014 年3 月~2015 年3 月，本院复发性缺血性脑卒中患者238 例(复发组)，性别和年龄匹配的初发缺血性脑卒中患者378 例(初发组)。比较两组患者的临床资料并进行非条件Logistic 回归分析；对比两组患者入院和出院时美国国立卫生研究院卒中量表(NIHSS)评分及神经功能好转率。结果复发组脑白质疏松(χ2=8.666)、高血压(χ2=8.189)、吸烟(χ2=6.973)、饮酒(χ2=4.722)的发生率高于初发组(P<0.05)。Logistic 回归分析显示，脑白质疏松(OR=1.690, 95%CI: 1.198~2.384, P=0.003)、高血压(OR=1.715, 95%CI: 1.135~2.592, P=0.010)、吸烟(OR=1.896, 95%CI: 1.233~2.915, P=0.004)是复发性缺血性脑卒中的独立危险因素。复发组入院及出院NIHSS 评分均显著高于初发组(t=-3.645,t=-4.675, P<0.001)，神经功能好转率明显低于初发组(t=2.643, P<0.01)。结论高血压、脑白质疏松、吸烟是复发性缺血性脑卒中的独立危险因素，复发性缺血性脑卒中患者较初发者病情严重，短期神经功能恢复慢。

关键词: 缺血性脑卒中, 复发, 危险因素, 美国国立卫生研究院卒中量表, 预后

Abstract: Objective To investigate the risk factors of recurrent ischemic stroke, and evaluate the severity and short- term outcome. Methods From March, 2014 to March, 2015, 238 patients with recurrent ischemic stroke and 378 patients with initial ischemic stroke matched with gender and age were enrolled. The clinical data of two groups were compared and the non-conditional Logistic regression model was made to analysis the risk factors of recurrent ischemic stroke. The National Institute of Health Stroke Scale (NIHSS) score as admission and discharge, and the neural function improvement rate of two groups were compared. Results The incidences of leukoarailsis (χ2= 8.666), hypertension (χ2=8.189), smoking (χ2=6.973) and alcohol consumption (χ2=4.722) were higher in the recurrent group than in the primary group (P<0.05). Logistic regression analysis showed that leukoarailsis (OR=1.690, 95%CI: 1.198~2.384, P=0.003), hypertension (OR= 1.715, 95%CI: 1.135~2.592, P=0.010) and smoking (OR=1.896, 95%CI: 1.233~2.915, P=0.004) were the independent risk factors of recurrent ischemic stroke. The NIHSS scores as admission and discharge were significantly higher (t=-3.645, t=-4.675, P<0.001), and the neural function improvement rate was lower (t=2.643, P<0.01) in the recurrent group than in the primary group. Conclusion Hypertension, leukoarailsis and smoking are independent risk factors for recurrent ischemic stroke. Recurrent ischemic stroke is more serious than initial ischemic stroke, and the short-term neural function recovers more slowly.

Key words: ischemic stroke, recurrent, risk factor, National Institute of Health Stroke Scale, outcome