老年脑梗死后1年内复发的高危因素及二级预防干预措施

High risk factors and secondary prevention measures for recurrence in the elderly within 1 year after cerebral infarction

目的分析老年脑梗死患者1 a内复发的高危因素及二级预防干预措施。方法选取2021-04—2022-04四川大学华西医院上锦医院收治的92例老年脑梗死患者为研究对象,依据患者1 a内是否复发分为复发组与未复发组,对比2组患者的临床资料,分析老年脑梗死后1 a内复发的高危因素,探讨二级预防干预措施对复发率的改善作用。结果21例老年脑梗死患者后1 a内复发,复发率为22.83%(21/92)。单因素及多因素Logistic回归分析显示,吸烟、血压控制欠佳、高同型半胱氨酸(Hcy)、高胱抑素C(Cys-C)为老年脑梗死1 a内复发的高危因素(分别为OR=1.432、1.866、1.709、1.611,P<0.05)。采取二级预防干预措施的老年脑梗死患者1 a内复发率低于未采取相应措施者,差异有统计学意义(P<0.05)。结论老年脑梗死患者1 a内复发率高,吸烟、血压控制欠佳、高Hcy、高Cys-C为其高危因素,采取相应的二级预防干预措施可降低复发率。

Objective To analyze the high risk factors and secondary prevention measures for recurrence in the elderly within 1 year after cerebral infarction.Methods A total of 92 elderly patients with cerebral infarction who were admitted to Shangjin Hospital,West China Hospital,Sichuan University from April 2021 to April 2022 were selected as the research subjects.They were divided into the recurrence group and the non-recurrence group according to the presence or absence of recurrence within 1 year.Clinical data of the two groups were comparatively analyzed to screen the high risk factors for recurrence in the elderly within 1 year after cerebral infarction.The effect of secondary prevention on the recurrence rate was discussed.Results Twenty-one elderly patients with cerebral infarction had recurrence within 1 year,with a recurrence rate of 22.83%(21/92).Univariate analysis and multivariate Logistic regression analysis found that smoking,poor blood pressure control,high homocysteine(Hcy),and high cystatin C(Cys-C)were high risk factors for recurrence in the elderly within 1 year after cerebral infarction(OR=1.432,1.866,1.709,1.611,respectively,P<0.05).The recurrence rate within 1 year was lower in patients receiving secondary prevention than those not receiving corresponding secondary prevention measures(P<0.05).Conclusion The recurrence rate of cerebral infarction in the elderly is high within 1 year.Smoking,poor blood pressure control,high Hcy,and high Cys-C levels are high risk factors.Secondary prevention measures can reduce the recurrence rate.