复发性脑梗死相关因素研究

Study on Related Factors of Recurrent Cerebral Infarction

目的探讨复发性脑梗死的相关因素。方法选取2008年1月—2010年12月191例复发性脑梗死患者及525例同期入院的首发脑梗死患者的临床资料进行对照分析,并对其相关因素进行多因素非条件Logistic回归分析。结果两组性别构成,糖尿病、饮酒、肾功能不全及蛋白尿发生率,血小板计数、同型半胱氨酸、尿酸、肌酐、C反应蛋白、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白及高密度脂蛋白水平比较,差异均无统计学意义(P>0.05)。复发组年龄>60岁、有脑梗死家族史者所占比例,高血压、冠心病、吸烟、心房纤颤、慢性支气管炎及高纤维蛋白原发生率与对照组比较,差异均有统计学意义(P<0.05)。进一步进行多因素非条件Logestic回归分析,其中年龄>60岁〔OR=2.021,95%CI(1.336,3.058),P=0.001〕、高血压〔OR=1.717,95%CI(1.054,2.796),P=0.030〕、高纤维蛋白原〔OR=1.492,95%CI(1.048,2.123),P=0.026〕进入回归方程。结论脑梗死复发是多因素的,年龄>60岁、高血压、高纤维蛋白原是复发性脑梗死的主要危险因素,针对可控制因素的治疗是预防脑梗死复发的重要途径之一。

Objective To explore the risk factors for recurrent cerebral infarction. Methods Clinical data of 191 patients with recurrent cerebral infarction and 525 patients with first time cerebral infarction from January 2008 to December 2010 were comparatively analyzed and multivariate unconditional Logistic regression analysis were used to analyze related factors. Results The sex ratio,diabetes,drinking,renal insufficiency,incidence of proteinuria,platelet count,homocysteine（HCY）,uric acid,creatinine,C-reactive protein,fasting blood glucose,total cholesterol,triacylglycerol,LDL and HDL showed no statistically significant differences between the two groups（P0.05）.Compared with control group,age60,history of cerebral infarction,hypertension,coronary disease,smoking,atrial fibrillation,chronic bronchitis and the incidence of hyperfibrinogenemia in recurrent group showed statistically significant differences（P0.05）.Multivariate unconditional logistic regression analysis showed that age60（OR=2.021,95%CI（1.336,3.058）,P=0.001）,hypertension（OR=1.717,95%CI（1.054,2.796）,P=0.030） and hyperfibrinogenemia（OR=1.492,95%CI（1.048,2.123）,P=0.026） entered the regression equation. Conclusion Cause of stroke recurrence is multifactorial,age60 years,history of hypertension and hyperfibrinogenemia are the risk factors for cerebral infarction recurrence,so intervention measures on controllable factors should be taken to prevent cerebral infarction recurrence.