老年缺血性脑卒中患者危险因素聚集情况分析

Prevalence of risk factors in aged patients with ischemic stroke

目的分析老年缺血性脑卒中(IS)患者危险因素聚集情况。方法采用便利抽样法,选取2021年7月至2022年6月于北京医院神经内科及神经外科住院治疗的60岁及以上IS患者作为调查对象,采用自行设计的问卷进行调查,问卷内容包括调查患者人口学特征(性别、年龄、身高、体质量、文化程度、入院方式、发病形式、是否吸烟、是否饮酒)及慢性病史(是否患有高血压、冠心病、糖尿病、高脂血症、房颤),采用SPSS 22.0软件进行统计学分析,不同人口学特征危险因素发生率及不同危险因素聚集情况采用χ2检验或Fisher确切概率法,危险因素聚集情况影响因素采用多分类Logistic回归分析。结果本研究共纳入190例老年IS患者,高血压、冠心病、糖尿病、高脂血症、房颤、超重或肥胖、吸烟、饮酒的检出率分别为73.7%、30.0%、40.5%、51.6%、8.9%、61.1%、45.8%、40.5%。初中及以下学历患者≥4个危险因素聚集率为32.4%,相较于高中及以上学历患者≥4个危险因素聚集率(16.5%)更高,差异有统计学意义(χ2=7.377,P<0.05)。农村患者≥4个危险因素聚集率为28.0%,相较于城市患者≥4个危险因素聚集率(4.5%)更高,差异有统计学意义(P<0.05)。Logistic回归分析结果显示:初中及以下学历患者≥4个危险因素聚集情况比例高于高中及以上学历患者(OR=4.857,95%CI:1.063~22.191,P=0.041);农村患者≥4个危险因素聚集情况比例高于城市患者(OR=23.500,95%CI:2.095~263.597,P=0.010)。结论老年IS患者危险因素聚集与性别和居住地相关,且危险因素倾向于集合出现。应重点针对危险因素聚集高、文化程度低、农村居民进行心脑血管疾病的防治工作。

ObjectiveTo analyze the aggregation of risk factors in elderly patients with ischemic stroke.MethodsConvenience sampling method was used to select ischemic stroke patients aged 60 years or older who were hospitalized in the Department of Neurology and Neurosurgery of a Grade-A tertiary hospital in Beijing from July 2021 to June 2022 as subjects. A self-designed questionnaire was used to investigate the demographic characteristics of the patients (gender, age, height, weight, education level, way of admission, form of disease, smoking and drinking) and chronic medical history (hypertension, coronary heart disease, diabetes, hyperlipidemia and atrial fibrillation). SPSS 22.0 software was used for statistical analysis. The incidence of different demographic risk factors and the aggregation of different risk factors were analyzed by chi-square test or Fisher's exact probability method, and the influencing factors of the aggregation of risk factors were analyzed by multiple logistic regression.ResultsA total of 190 elderly patients with ischemic stroke were included in this study. The detection rates of hypertension, coronary heart disease, diabetes mellitus, hyperlipidemia, atrial fibrillation, overweight or obesity, smoking, and alcohol consumption were 73.7%, 30.0%, 40.5%, 51.6%, 8.9%, 61.1%, 45.8%, 40.5%, respectively. The aggregation rate of ≥4 risk factors in patients with junior high school education or below was 32.4%, which was higher than that in patients with senior high school education or above (16.5%), the difference was statistically significant (χ2=7.377, P<0.05). The aggregation rate of ≥4 risk factors in rural patients was 28.0%, which was higher than that of ≥4 risk factors in urban patients (4.5%), the difference was statistically significant (P<0.05). Logistic regression analysis showed that patients with junior high school education or below had a higher proportion of ≥4 risk factors than those with senior high school education or above (OR=4.857, 95%CI: 1.063-22.191, P=0.041). The proportion of ≥4 risk factors in rural patients was higher than that in urban patients (OR=23.500, 95%CI: 2.095-263.597, P=0.010).ConclusionsThe aggregation of risk factors in elderly ischemic stroke patients is related to gender and place of residence, and the risk factors tended to be aggregated. The prevention and treatment of cardiovascular and cerebrovascular diseases should focus on rural residents with multiple risk factors and low education levels.