脑梗死患者死亡原因的探讨

Research on the mortal mechanism of cerebral infarction

目的探讨脑梗死患者死亡的原因。方法对1 457例脑梗死死亡患者的年龄、高血压、糖尿病、冠心病、心房颤动、血脂异常及并发症进行相关分析,并与脑梗死非死亡患者进行对照研究。结果脑梗死患者总病死率为2.68%,其中首次脑梗死的病死率1.10%,复发脑梗死的病死率9.35%,两者差异有显著性意义(P<0.01),复发性脑梗死病死率为初发脑梗死病死率的9倍。发病后2周内死亡占82.05%,死亡年龄65岁以上居多(占75.00%)。脑梗死死亡者多有高血压和(或)糖尿病,死亡前多有并发症(以肺部感染为主,脑梗死合并肺部感染等2种或以上并发症,是脑梗死的主要死亡原因)。结论高龄、高血压、冠心病、心房颤动、糖尿病和复发性脑梗死是脑梗死患者死亡的重要因素,并发症是导致脑梗死患者死亡的直接原因,并发症越多,脑梗死患者病死率越高。

Objective To study the modal mechanism of cerebral infarction. Methods The age, hypertension, diabetes, coronary heart disease, atrial fibrillation, abnormal blood lipids and complications in patients who died of cerebral infarction were analyzed and compared with those in the survivors of cerebral infarction. Results The fatality rate in patients with cerebral infarction was 2.68 %, among which, the fatality of first attack of cerebral infarction was 1.10% and that of recurrent cerebral infarction was 9.35 %, with significant difference between these 2 groups（ P 〈 0.01 ）. The fatality rate of recurrent cerebral infarction was 9 times that of first attack of cerebral infarction. 75.00% of deceased cerebral infarction patients were older than 65. Most deceased cerebral infarction patients had hypertension, diabetes and complications. Conclusions Old age, hypertension, coronary heart disease, atrial fibrillation, diabetes and complications are fatal factors in the cerebral infarction patients. Complications are the direct cause of death in patients with cerebral infarction. The more the complications, the higher the fatality rate of cerebral infarction patients.