脑梗死患者5年复发的相关因素研究

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (798 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore the risk factors of 5-year recurrence in patients with cerebral infarction and construct a prognostic index model to predict recurrence, so as to provide reference for relapse prediction in patients with cerebral infarction. Methods Two hundred and eighty patients with primary incipient ischemic stroke diagnosed in Ningbo First Hospital of Zhejiang Province from January to December 2011 were selected as the research objects, and the recurrence conditions of patients were followed up, and all the follow-up work was finished until December 2016. Kaplan-Meier method was used to analyze the overall recurrence rate, the Cox proportional risk regression model was used to make single-factor and multiple-factor analysis of the risk factors of affecting the recurrence of patients, so as to build recurrence model and individual prognostic index (PI). Results At the end of follow-up, total 38 patients experienced recurrence. The 1-year recurrence rate was 4.8 per person-year, the 2-year recurrence rate was 5.6 per person-year, the 3-year recurrence rate was 7.5 per person-year, the 4-year recurrence rate was 9.7 per person-year and the 5-year recurrence rate was 10.5 per person-year. The single-factor and multiple-factor analysis of Cox proportional risk regression model showed that the independent risk factors of affecting the recurrence of cerebral infarction patients were age (X1, RR = 1.302; 95%CI: 1.018-1.652), the history of hypertension (X2, RR = 0.682; 95%CI: 1.015-3.862), the history of heart disease (X3, RR = 1.765; 95%CI: 1.126-2.865), total cholesterol (X4, RR = 2.136; 95%CI: 1.412-3.267) and family history of stroke (X5, RR = 2.657; 95%CI: 1.172-5.864). Thus, the PI equation of the recurrence model was established: PI = 0.025X1 + 0.681X2 + 0.581X3 + 0.395X4 + 0.973X5). Conclusion The age, history of hypertension, history of heart disease, total cholesterol, and family history of stroke are independent risk factors of affecting medium-long term recurrence in patients with cerebral infarction. The cerebral infarction PI equation of predicting recurrence within 5 years has good effects, which has predictive value for the recurrence of cerebral infarction.

Key words： Cerebral infarction Recurrence Risk factors Cox regression model Prognostic index

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Fang1 YAO Zhiping2

Cite this article:

WANG Fang1 YAO Zhiping2. Study on the related factors of 5-year recurrence in patients with cerebral infarction[J]. 中国医药导报, 2018, 15(2): 67-70,82.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I2/67

[1] 周锦霞，李国珍，程伟，等.大动脉粥样硬化型脑梗死与穿支动脉疾病型脑梗死的临床特点对比[J].重庆医学，2017，46（4）：513-516.
[2] 李永琴，陈飞，张微微，等.脑微出血与脑梗死的相关性研究[J].中华老年心脑血管病杂志，2017，19（6）：615-618.
[3] 陈于祥，陈于兰，瞿伦学，等.老年人脑梗死复发的相关危险因素分析[J].重庆医学，2013，45（24）：2839-2841.
[4] 房位昊，周莉，刘强，等.复发脑梗死危险因素及中医证候特征研究[J].吉林中医药，2015，38（7）：671-674.
[5] 郑硕，张允岭，孙静宜，等.颈动脉粥样硬化与缺血性卒中的关系及中医证候要素演变分析[J].世界中医药，2017， 12（3）：655-660，665.
[6] 袁婷婷，邹晓毅.脑梗死继发癫（癎）的研究进展[J].中华老年心脑血管病杂志，2012，14（3）：330-332.
[7] 侯晓雯，王冲，陈欣，等.中国人群H型高血压与脑梗死关系的Meta分析[J].中国全科医学，2015，19（11）：1232-1235，1239.
[8] 江颖，方兴，张永全，等.活血化瘀法治疗缺血性卒中的研究进展[J].世界中医药，2016，11（5）：936-940.
[9] 涂雪松.缺血性脑卒中的流行病学研究[J].中国临床神经科学，2016，24（5）：594-599.
[10] 张文婷，陈茂刚，张敏，等.缺血性脑卒中复发与相关因素分析[J].中华老年心脑血管病杂志，2012，14（2）：168-171.
[11] 张红梅，方向华，刘宏军，等.中老年缺血性脑卒中患者伴糖尿病和空腹血糖调节受损对脑卒中复发的影响[J].中国老年学杂志，2012，32（19）：4121-4123.
[12] 王娟.复发性脑梗死相关因素研究[J].中国全科医学，2013，16（3）：246-248.
[13] 王伟英，桑文文，焉双梅，等.急性缺血性脑卒中患者1年复发危险因素Cox回归分析[J].中华老年心脑血管病杂志，2016，18（1）：46-50.
[14] 侯晓雯，王冲，陈欣，等.中国人群H型高血压与脑梗死关系的Meta分析[J].中国全科医学，2015，19（11）：1232-1235，1239.
[15] 李琦，钟纯正.急性缺血性脑卒中复发危险因素分析及低密度脂蛋白与高密度脂蛋白比值对脑卒中复发的预测价值[J].中国循环杂志，2014，31（9）：694-697.
[16] 王渝蓉，余晓霞.化痰祛瘀汤对脑梗死患者的治疗效果及血液流变学、血流动力学的影响[J].环球中医药，2016， 9（7）：856-858.
[17] 陈茂玉，郑志雄.青年多发性脑梗死的危险因素、病因及预后探讨[J].中国现代医生，2016，54（33）：37-39.
[18] 艾克拜尔·安尼瓦尔，李俊红，木拉提·阿不都热合曼.心房颤动治疗的研究新进展[J].中国循环杂志，2014， 29（11）：955-957.
[19] 包新杰，李雪元，左赋兴，等.稳定的大鼠大脑中动脉栓塞脑梗死模型的建立[J].中国实验动物学报，2016，24（4）：395-398.
[20] 萧云.负荷剂量氢氯格雷联合大剂量阿托伐他汀治疗进展性脑梗死的有效性[J].现代医院，2017，17（4）：576-578.
[21] 周艳茹，闫秀纵，刘秀荣，等.基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响[J].实用预防医学，2012， 19（7）：1084-1086.
[22] Kamouchi M，Kumagai N，Okada Y，et al. Risk score for predicting recurrence in patients with ischemic stroke：the Fukuoka stroke risk score for Japanese [J]. Cerebrovasc Dis，2012，34（5/6）：351-357.
[23] Kuwashiro T，Sugimori H，Kamouchi M，et al. Lower levels of high-density lipoprotein cholesterol on admission and a recurrence of ischemic stroke：A 12-month follow-up of the Fukuoka Stroke Registry [J]. J Stroke Cerebrovasc Dis，2012，21（7）：561-568.
[24] 云霞.急性脑梗死患者治疗效果影响因素分析[J].中国现代医生，2016，54（35）：36-39.
[25] 安雅臣，王玉浔，张江，等.缺血性脑卒中复发预测模型的构建及应用[J].实用医学杂志，2013，29（7）：1095-1097.