代谢综合征及相关因子对缺血性脑卒中再发的影响研究

Effect of metabolic syndrome and related factors on recurrence of ischemic stroke

目的探讨代谢综合征及相关因子和缺血性脑卒中再发的关系。方法选取2013年5月至2014年5月在该院门诊和住院的新发缺血性脑卒中患者90例,其中4例患者出现脑出血被排除,总共有86例患者纳入研究。对86例患者进行基本资料的调查,出院1年后进行电话回访和门诊随访,对再发脑卒中的患者进行调查和统计。结果经过1年的随访调查,86例缺血性脑卒中患者共再发24例(27.9%),再发患者中有2例(8.3%)因大面积脑梗死出现死亡。单因素分析可见吸烟、血糖升高、高血压、低密度胆固醇升高、高尿酸、高同型半胱氨酸、颈动脉粥样硬化狭窄与缺血性脑卒中再发相关(P<0.05)。多因素Logistic回归分析结果可见上述7种因素均为缺血性脑卒中再发的危险因素。结论控制首次卒中后的危险因素作为一种长期策略对缺血性脑卒中的二级预防具有重要临床意义。

Objective To investigate the relationship between metabolic syndrome and related factors and recurrence of is- chemic stroke. Methods 90 in-and out-patients with ischemic stroke in Jiangbei District Hospital of Traditional Chinese Medicine during May 2013 and May 2014 were enrolled. In 90 cases,4 patients with cerebral hemorrhage were excluded. Basic data of the 86 patients were investigated, which including gender, age, abdominal circumference, smoking, drinking, family history of stroke, diabe- tes, hypertension, hyperlipidemia, a history of atrial fibrillation, transient ischemic attacks, fasting blood glucose, triglyceride, choles- terol, uric acid,homocysteine, urinary protein-creatine ratio, carotid ultrasound examination. We investigated patients with or with- out recurrent stroke during one year of telephone visit and follow-up. Patients with recurrent stroke were investigated. Results During the one year follow-up,24 cases in the 86 patients with ischimic stroke were recurrent,the recurrence rate was 27.9%. 2 ca- ses in the recurrent patients died because of massive cerebral infarction,accounted for 8.3% of the patients with recurrent stroke. According to Chi-square test, smoking, high fasting plasma blood glucose, hypertension, elevated low density lipoprotein cholesterol, high uric acid,high homocysteine and carotid atherosclerosis all had correlation with recurrent stroke（P〈0.05）. In this logistic-re- gression model, smoking, high fasting plasma blood glucose, hypertension, elevated low density lipoprotein cholesterol, high uric acid,high homocysteine and carotid atherosclerosis were all predictors for recurrence of ischemic stroke. Conclusion Cntrolling the risk factors after the first stroke as a long-term strategy has important clinical significance for secondary prevention of ischemic stroke.