无症状性脑梗死患者危险因素的随访研究

Follow-up of risk factors for asymptomatic ischemic stroke

目的观察无症状性脑梗死(silent brain infarction,SBI)患者危险因素的长期控制状况。方法选择SBI患者145例,给予控制危险因素并随访1年;按照控制顺应性分为规范控制组108例和不规范控制组37例;并对随访前后危险因素的分布、治疗率及达标率进行比较。结果随访1年,SBI患者高脂血症、心房颤动、高同型半胱氨酸血症的用药率均较基线时明显提高(92.3%vs 82.4%,92.3 vs 46.2%,95.8%vs 56.3%,P<0.05);高同型半胱氨酸血症、戒烟、戒酒等的控制达标率较基线时的明显提高(89.6%vs 54.2%,91.0 vs 53.8%,97.9%vs 76.6%,P<0.01)。与不规范控制组比较,规范控制组血糖、同型半胱氨酸血症控制达标率明显改善;空腹血糖、餐后2h血糖、同型半胱氨酸水平明显下降,差异有统计学意义(P<0.05,P<0.01)。结论 SBI患者危险因素多,但多可通过规范化生活方式及药物治疗来控制并达标。

Objective To observe the long-term control of risk factors for asymptomatic ischemic stroke. Methods One hundred and forty-five asymptomatic ischemic stroke patients were includ- ed in this study. Their risk factors were controlled. The patients were followed up for 1 year. The patients were divided into standard control group（n= 108） and.non-standard control group（n= 37） according to their compliance. Distribution of risk factors,curative rate and risk factors control rate in two groups were analyzed and compared before and after follow-up. Results The patients were followed up for 1 year. Hyperlipidemia, atrial fibrillation, hyperhomocysteinemia, smoking and wine-drinking abstinence were significantly improved in asymptomatic ischemic stroke patients after treatment（92.3% vs 82.4% ,92.3 vs 46.2%,95.8% vs 56.3% ,P〈0.05）. The blood glucose level and hyperhomocysteinemia were better controlled in standard control group than in non-standard control group（89.6% vs 54.2%,91.0% vs 53.8%,97.9% vs 76.6%, P〈0.01）. The levels of fasting blood glucose, 2 h postprandial blood glucose and homocysteine were significantly lower in asymptomatic ischemic stroke patients after treatment than before treatment （P〈0.05,P〈0.01）. Conclusion The risk factors for asymptomatic ischemic stroke are numerous, but most of them can be controlled through standard life style and drug treatment.