甘肃地区缺血性脑卒中患者卒中认知调查及影响因素分析

A survey of stroke awareness and influential factors among acute ischemic stroke patients in Gansu Province

目的调查缺血性卒中患者对卒中危险因素、预警症状及溶栓治疗认知情况,并探索影响卒中认知的相关因素。方法自2015年3月至2015年9月期间,使用结构式问卷横断面调查缺血性卒中患者对卒中的认知,分析卒中认知与可能影响卒中认知的相关因素,采用单因素及多因素回归分析探索影响缺血性卒中患者卒中认知的因素。结果共调查了138例就诊于兰州大学第一医院神经内科的缺血性卒中患者,年龄(63.53±11.41)岁,男性89例(60.1%)。认知率最高的卒中危险因素是高血压(64.5%),卒中症状是偏侧肢体无力(60.1%);知道溶栓治疗5.8%,知道溶栓治疗时间窗为1.4%。单因素回归分析显示文化程度与识别3个及以上卒中危险因素(P=0.036)和卒中症状(P=0.042)、知道溶栓治疗(P=0.045)及时间窗(P=0.017)都有关。多因素回归分析显示发病时能识别卒中症状(OR=0.252,P=0.012)是识别3个及以上卒中危险因素的独立预测因素;使用非正规降压药物(OR=1.344,P=0.024)和发病后急诊转运途径(OR=0.662,P=0.05)是识别3个及以上卒中症状的独立预测因素;发病时能识别卒中症状(OR=2 249.238,P=0.032)是知道卒中溶栓治疗的独立预测因素。结论急性缺血性脑卒中患者对卒中危险因素、症状及溶栓治疗的认知率低,更高的文化程度和卒中高认知率有关。

Objective To explore the awareness of stroke warning signs,risk factors and thrombolytic therapy of acute ischemic stroke,and to determine the influential factors associated with the level of stroke knowledge.Methods Cross sectional surveys about the awareness of acute ischemic stroke were conducted with a structured questionnaire during March and Sept.2015.The relationship between the knowledge of stroke and pre-hospital delay,degree of neurological deficit,initial symptoms,response to stroke onset,status when stroke happened,previous medical history and demographic information were analyzed.Factors associated with stroke awareness were investigated with the help of univariate and multivariate regression analysis.Results A total of 138 acute ischemic stroke patients were interviewed,including 89 males and 49 females.The patients＇mean age was 63.53±11.41 years.Weakness（60.1%）was the most commonly identified stroke sign,and hypertension（64.5%）was the most commonly identified stroke risk factors.Of all respondents,5.8% knew thrombolytic therapy and 1.4% knew thrombolytic time window.Univariate regression analysis demonstrated that educational level was associated with knowing three or more stroke risk factors（P =0.036）,three or more stroke warning signs（P =0.042）,thrombolytic therapy（P=0.045）and time window of thrombolytic therapy（P=0.017）.Multivariate regression analysis indicated that recognizing initial symptom as stroke was the independent predictor of knowing three or more stroke risk factors（OR =0.252,P=0.012）and thrombolytic therapy（OR =2 249.238,P=0.032）,taking informal antihypertensive drugs（OR =1.344,P =0.024）,and using emergency medical services（EMS）as transporting pathway（OR=0.662,P=0.05）were independent factors of knowing three or more stroke signs.Conclusion The awareness of stroke warning signs,risk factors and thrombolytic therapy were obviously inadequate among acute ischemic stroke patients.Higher educational level was predictor of more stroke awareness.