新疆地区810例缺血性卒中前瞻性登记研究结果

Prospective Registration Results of 810 Ischemic Stroke Cases in XinJiang

目的总结2005年5月～2009年10月在新疆生产建设兵团医院卒中注册项目中注册的810例卒中患者的基本情况、临床特点和危险因素,以期为卒中的临床防治提供参考。方法本研究参照瑞士洛桑卒中登记(Lausanne Stroke Registry)研究方法,采用前瞻性医院单中心系统调查方法,记录卒中患者一般情况、既往史、生活情况、发病至就诊时间、卒中评分,分别在发病后1月、3月、6月和1年由两名医师进行电话随访,并对随访者采用盲法。结果纳入810例患者,其中:男性478例(59.01%),女性332例(40.99%);汉族788例,维族13例,回族9例。平均年龄66.50±10.66岁;年失访率4.64%;诊断急性脑梗死769例,短暂性脑缺血发作(TIA)41例。患者从发病到救治的中位时间为15小时。腔隙性梗死是最多见的缺血性脑卒中亚型,有334例患者(43.43%)。入院卒中(NIHSS)评分平均为5.55±7.24。患者颈动脉斑块发生率最高(82.2%),采用静脉rt-PA溶栓治疗的患者37例(4.57%)。结论新疆地区卒中有自己的特点,患者颈动脉斑块发生率最高,而溶栓治疗的比例高于全国130家医院平均水平,良好的卒中登记制度规范了临床医疗行为,促进了医疗质量的不断提高。

Objective The baseline,clinical characteristics,and risk factors were analyzed in the stroke registry program of the Xinjiang Production Constraction Corp’s Hospital aimed to aid the clinical management and stroke prevention.Method A single center prospective method based on Lausanne Stroke Registry was used in this study.Patients generally,past history,living conditions,onset to treatment time,the stroke scale were collected with 1 year follow up.The investigators of follow up were single blinded.Result Eight hundred and ten ischemic stroke patients were included,of which 478（59.01%） were male,332（40.99%） were female.The average age of these patients was 66.50±10.66 years.One year loss rate of follow up was 4.64%.Seven hundred and sixty-nine patients were diagnosis as acute cerebral infarction,41 patients were TIA.The median time from onset to treatment was 15 hours.Lacunar infarction was the most common type with 334（43.43%） patients.The average score of the National Institutes of Heath Stroke Scale was 5.55±7.24.The incidence of carotid artery plaque was 82.2%.Conclution Xinjiang region has its own characteristics of stroke with a higher carotid artery plaque rate and thrombolytic therapy ratio.Good stroke registration system could standardize the clinical behavior and promote the continuous improvement of medical quality.