再发脑梗死的危险因素研究

Study on the risk factors in recurrent cerebral infarction

目的:探讨脑梗死再发的原因和危险因素。方法:对41例脑再梗死患者及112例随访未再发的初次脑梗死患者的临床伴发疾病及血脂代谢、凝血、纤溶系统、血浆同型半胱氨酸水平进行了综合分析。结果:脑再梗死伴高血压者明显多于初次脑梗死者,而伴糖尿病、缺血性心脏病者无此现象;脑再梗死者血PA I-1活性和纤维蛋白原水平显著高于初次脑梗死者;无论是初次脑梗死还是再发脑梗死血浆同型半胱氨酸均明显升高。结论:高血压、血纤溶系统活性升高、高水平纤维蛋白原、高同型半胱氨酸血症是脑梗死再发的重要危险因素。

Objective To study the pathogeneses and risk factors in recurrent cerebral infarction. Methods The combined diseases and the biochemical parameters were followed up for over 6 months, including plasma TG, TC, LDL, HDL, apoA- 1 ,apoB, tPA, PAL-1, Fb and Hcy in 41 patients with recurrent cerebral infarction and 112 patients with one cerebral infarction. Results The incidence of recurrent cerebral infarction was more frequent in those complicated with hypertension than those in the patients with one cerebral infarction, while the patients with diabetes or ischemic heart diseases had no difference. The plasma PAI-1 activity and fibrinogen level in the patients with recurrent infarction were significantly higher than those of the patients with first cerebral infarction; Plasma Hcy level was obviously higher not only in the first cerebral infarction but also in the recurrent cerebral infarction. Conclusion Hypertension, increased plasma PAI-1 activity, fibrinogen level and plasma Hcy level are the important risk factors in the recurrent cerebral infarction.