缺血性卒中后功能性消化不良严重程度的影响因素研究

Influencing Factors of Severity of Functional Dyspepsia after Ischemic Stroke

背景缺血性卒中后功能性消化不良(FD)属于卒中后胃肠功能紊乱的一种,在中老年患者中十分普遍。卒中患者由于自身躯体与心理的变化,其FD的影响因素可能与一般人群存在差异。目的探讨缺血性卒中后FD严重程度的影响因素。方法连续选取2017年3月至2018年7月在天津中医药大学第一附属医院针灸科住院治疗的缺血性卒中后并发FD的中老年患者180例,住院期间采用自拟消化不良症状积分量表对患者FD严重程度进行评估,按照量表评分结果将患者分为轻度FD组(评分≤7分,n=115)和中重度FD组(评分>7分,n=65)。通过病历系统收集患者资料,采用多因素Logistic回归探究缺血性卒中后FD严重程度的影响因素。结果180例患者FD症状评分3~12分,平均(7.2±1.7)分,其中115例(63.9%)患者症状评分≤7分,65例(36.1%)患者症状评分>7分。不同年龄(43~55岁、>55岁)和卒中病程(急性期、恢复期、后遗症期)缺血性卒中患者FD严重程度比较,差异有统计学差异(P<0.05)。多因素Logistic回归分析结果显示,年龄43~55岁〔OR=3.367,95%CI(1.399,8.104),P=0.007〕以及丘脑梗死〔OR=2.111,95%CI(1.038,4.290),P=0.039〕是缺血性卒中后FD严重程度的危险因素。结论年龄43~55岁和丘脑梗死是缺血性卒中患者FD严重程度的危险因素,可作为评估FD发展的依据,为临床医生对缺血性卒中患者FD的早期干预提供参考。

Background Functional dyspepsia(FD)after ischemic stroke belongs to the category of post-stroke gastrointestinal dysfunction,which is prevalent in middle-aged and elderly patients.Stroke patients may differ from the general population in the influencing factors of FD due to their own somatic and psychological changes.Objective To investigate the associated factors of the severity of functional dyspepsia after ischemic stroke.Methods A total of 180 middle and old aged patients with functional dyspepsia after ischemic stroke were selected from March 2017 to July 2018 in the Department of Acupuncture of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine.A self-designed dyspepsia symptom score scale was used to evaluate the severity of FD during hospitalization.The patients were divided into mild FD group(score≤7,n=115) and moderate-severe FD group (score>7,n=65)according to the dyspepsia symptom score.Patient data were collected through the medical record system,and multivariate Logistic regression were used to explore the influencing factors of functional dyspepsia severity after ischemic stroke.Results The FD symptom scores of 180 patients was in the range of 3-12 points,with an average of(7.2±1.7)points.Among them,115 patients(63.9%)had symptom score≤7 points,and 65 patients(36.1%)had symptom score>7 points.The severity of functional dyspepsia patients with different ages and stroke duration (acute,convalescent,sequelae) was statistically different(P<0.05).Multivariate Logistic regression analysis showed middle age(43-55 years)〔OR=3.367,95% CI(1.399,8.104),P=0.007〕and thalamus infarction〔OR=2.111,95%CI(1.038,4.290),P=0.039〕were the influencing factors of the severity of functional dyspepsia after ischemic stroke.Conclusion Age 43 to 55 years and thalamic infarction are risk factors for FD severity in patients with ischemic cerebral infarction,which may be used as a basis to evaluate the development of FD and provide a reference for clinicians for early intervention of FD in patients with ischemic stroke.