缺血性脑卒中患者二级预防现状及病情再发的影响因素
|
摘要
目的 了解缺血性脑卒中患者二级预防现状,探讨脑卒中再发的危险因素。方法 纳入2016年6月至2017年6月在本院门诊就诊的缺血性脑卒中患者251例,通过当面询问和查询门诊病历收集患者的年龄、性别、体重,是否吸烟、饮酒、中风家族史,是否诊断为高血压、糖尿病、房颤,总胆固醇是否异常,是否接受抗栓治疗等信息;根据6个月内脑卒中再发次数,分为观察组(再发性脑卒中≥1次)和对照组(未再发性脑卒中),分别探讨各因素对脑卒中复发的影响。结果 251例缺血性脑卒中患者中糖尿病207例(82.47%),控制率51.21%(106/207);高血压207例(82.47%),控制率49.76%(103/207);总胆固醇正常率51.79%(130/251);房颤患病率40.64%(102/251);吸烟率23.11%(58/251);抗栓治疗率58.17%(146/251)。6个月内再发脑卒中47例(18.72%)归为观察组,未再发脑卒中204例(81.28%)归为对照组。观察组患者吸烟、房颤、抗栓治疗的比例明显高于对照组,糖尿病控制率、高血压控制率、总胆固醇正常率明显低于对照组,差异均有统计学意义(均P<0.05)。进行多因素Logistic回归分析,高血压未控制、糖尿病未控制、总胆固醇异常、房颤是再发缺血性脑卒中的独立危险因素(均P<0.05)。结论 本地区缺血性脑卒中患者二级预防中高血压、糖尿病控制率较低,吸烟、房颤、胆固醇异常率较高,应针对独立危险因素做好防控工作。
Objective To understand the status of secondary prevention in patients with ischemic stroke and to explore the risk factors of recurrent stroke.Methods A total of 251 patients with ischemic stroke were enrolled from June 2016 to June 2017. Age, sex, weight, family history of smoking, drinking, stroke, diagnosis of hypertension, diabetes mellitus, atrial fibrillation, and abnormal total cholesterol were collected by face-to-face inquiry and inquiry. Whether to accept antithrombotic treatment; record the recurrence of stroke within 6 months, divided into observation group(recurrent stroke(≥1), control group(no recurrence of stroke).Results The prevalence of diabetes mellitus and blood glucose control was 82.47%(207/251) and 51.21%(106/207) respectively in 251 patients with ischemic stroke. 207(82.47%) in hypertension and 49.76%(103/207) in blood pressure control, 51.79%(130/251) in normal cholesterol, 40.64%(102/251) in atrial fibrillation, 23.11% in smoking, 58.17% in antithrombotic therapy, and 47(18.72%) in recurrent stroke within 6 months without recurrent stroke. There were 204 cases(81.28%). The proportion of smoking, atrial fibrillation and antithrombotic therapy in the observation group was significantly higher than that in the control group, and the control rate of diabetes mellitus, hypertension and the normal rate of total cholesterol are significantly lower than those in the control group(P<0.05). Normal atrial fibrillation was an independent risk factor for recurrent ischemic stroke.Conclusion The control rate of hypertension and diabetes mellitus, smoking, atrial fibrillation and abnormal cholesterol are lower in secondary prevention of ischemic stroke patients in this area, and the prevention and control of hypertension, diabetes mellitus, abnormal total cholesterol and atrial fibrillation should be strengthened.
Objective To understand the status of secondary prevention in patients with ischemic stroke and to explore the risk factors of recurrent stroke.Methods A total of 251 patients with ischemic stroke were enrolled from June 2016 to June 2017. Age, sex, weight, family history of smoking, drinking, stroke, diagnosis of hypertension, diabetes mellitus, atrial fibrillation, and abnormal total cholesterol were collected by face-to-face inquiry and inquiry. Whether to accept antithrombotic treatment; record the recurrence of stroke within 6 months, divided into observation group(recurrent stroke(≥1), control group(no recurrence of stroke).Results The prevalence of diabetes mellitus and blood glucose control was 82.47%(207/251) and 51.21%(106/207) respectively in 251 patients with ischemic stroke. 207(82.47%) in hypertension and 49.76%(103/207) in blood pressure control, 51.79%(130/251) in normal cholesterol, 40.64%(102/251) in atrial fibrillation, 23.11% in smoking, 58.17% in antithrombotic therapy, and 47(18.72%) in recurrent stroke within 6 months without recurrent stroke. There were 204 cases(81.28%). The proportion of smoking, atrial fibrillation and antithrombotic therapy in the observation group was significantly higher than that in the control group, and the control rate of diabetes mellitus, hypertension and the normal rate of total cholesterol are significantly lower than those in the control group(P<0.05). Normal atrial fibrillation was an independent risk factor for recurrent ischemic stroke.Conclusion The control rate of hypertension and diabetes mellitus, smoking, atrial fibrillation and abnormal cholesterol are lower in secondary prevention of ischemic stroke patients in this area, and the prevention and control of hypertension, diabetes mellitus, abnormal total cholesterol and atrial fibrillation should be strengthened.
引文
[1] 杨彬彬.社区居民脑卒中防治知信行现状及影响因素[J].中国卫生工程学,2018,17(4):572-574.
[2] 李文健,潘旭东,王静,等.缺血性脑卒中后二级预防药物依从性现状及对预后的影响[J].中华神经科杂志,2017,50(3):178-183.
[3] 陆敏智,黄鹏,仲玲玲,等.缺血性脑卒中患者近期功能预后影响因素分析[J].中华物理医学与康复杂志,2018,40(1):38-40.
[4] 王淳秀,吴晓光,刘宏军,等.北京市2013-2014年15岁及以上居民高血压患病率、知晓率、治疗率和控制率调查[J].中华流行病学杂志,2018,39(2):179-183.
[5] 郭杰,余灿清,吕筠,等.中国10个地区人群高血压患病率、知晓率、治疗率和控制情况分析[J].中华流行病学杂志,2016,37(4):469-474.
[6] 巩娟瑜.rt-PA或r-PA联合阿司匹林治疗急性脑梗死有效性及安全性分析[J].北华大学学报(自然科学版),2018,19(3):362-366.
[7] 王班,关天嘉,尤莉莉,等.我国缺血性脑卒中残疾情况及其影响因素分析[J].中国全科医学,2016,19(2):216-219.
[8] 刘广会.缺血性和出血性脑卒中危险因素分析[J].中国卫生工程学,2018,17 (02):260-262.
[9] Peyman Z,Raquel DM,Lavinia D,et al.Transcranial diffuse optical monitoring of microvascular cerebral hemodynamics after thrombolysis in ischemic stroke[J].Journal of Biomedical Optics,2014,19(1):1-4.
[10] 秦培英,禤彩霞,周钦,等.适量华法林在预防不同年龄段非瓣膜性房颤患者缺血性脑卒中的疗效观察[J].广西医科大学学报,2016,33(4):691-693.
[2] 李文健,潘旭东,王静,等.缺血性脑卒中后二级预防药物依从性现状及对预后的影响[J].中华神经科杂志,2017,50(3):178-183.
[3] 陆敏智,黄鹏,仲玲玲,等.缺血性脑卒中患者近期功能预后影响因素分析[J].中华物理医学与康复杂志,2018,40(1):38-40.
[4] 王淳秀,吴晓光,刘宏军,等.北京市2013-2014年15岁及以上居民高血压患病率、知晓率、治疗率和控制率调查[J].中华流行病学杂志,2018,39(2):179-183.
[5] 郭杰,余灿清,吕筠,等.中国10个地区人群高血压患病率、知晓率、治疗率和控制情况分析[J].中华流行病学杂志,2016,37(4):469-474.
[6] 巩娟瑜.rt-PA或r-PA联合阿司匹林治疗急性脑梗死有效性及安全性分析[J].北华大学学报(自然科学版),2018,19(3):362-366.
[7] 王班,关天嘉,尤莉莉,等.我国缺血性脑卒中残疾情况及其影响因素分析[J].中国全科医学,2016,19(2):216-219.
[8] 刘广会.缺血性和出血性脑卒中危险因素分析[J].中国卫生工程学,2018,17 (02):260-262.
[9] Peyman Z,Raquel DM,Lavinia D,et al.Transcranial diffuse optical monitoring of microvascular cerebral hemodynamics after thrombolysis in ischemic stroke[J].Journal of Biomedical Optics,2014,19(1):1-4.
[10] 秦培英,禤彩霞,周钦,等.适量华法林在预防不同年龄段非瓣膜性房颤患者缺血性脑卒中的疗效观察[J].广西医科大学学报,2016,33(4):691-693.