非心源性复发性脑梗死相关影响因素分析
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摘要
目的探讨非心源性复发性脑梗死的有关影响因素,为二级预防提供依据。方法将2016年8月～2018年6月于山东大学附属济南市中心医院神经内科住院的急性脑梗死患者1063例,分为初发和复发组,收集病例资料,采用Logistic回归分析各因素与非心源性复发性脑梗死的相关性。结果①两组间性别、年龄、吸烟率、饮酒率以及同型半胱氨酸、尿酸差别无统计学意义(P>0.05)。复发组与初发组相比,高血压、糖尿病发生率以及血清视黄醇结合蛋白、前白蛋白、白蛋白、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平差别有统计学意义(P<0.05)。②Logistic回归分析显示高血压、糖尿病、前白蛋白、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇有统计学意义(P<0.05)。结论脑梗死二级预防中除了高血压、糖尿病、血脂等多见的影响要素外,还应注意血清前白蛋白对于非心源性复发性脑梗死的重要保护作用。
Objective To investigate the related influencing factors of noncardiogenic recurrent cerebral infarction,and to provide a basis for secondary prevention.Methods Acute cerebral infarction patients,who were hospitalized at the department of neurology,Jinan Central Hospital Affiliated to Shandong University from August 2016 to June 2018,were divided into the primary group and the recurrent group.Logistic regression were used to analyze the correlation between various factors and noncardiogenic recurrent cerebral infarction.Results ①There were no statistically significant differences between the two groups in gender,age,smoking and drinking history,homocysteine and uric acid(P>0.05).The incidence of hypertension and diabetes,and the levels of serum retinol binding protein,prealbumin,albumin,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were statistically significant in the recurrent group compared with primary group(P<0.05).②Logistic regression analysis showed that the hypertension,diabetes,prealbumin,low density lipoprotein cholesterol and high density lipoprotein cholesterol were statistically significant(P<0.05).Conclusion In the secondary prevention of cerebral infarction,in addition to the common influencing factors such as hypertension,diabetes and blood lipid,the important protective effect of serum prealbumin on noncardiogenic recurrent cerebral infarction should also be emphasized.
Objective To investigate the related influencing factors of noncardiogenic recurrent cerebral infarction,and to provide a basis for secondary prevention.Methods Acute cerebral infarction patients,who were hospitalized at the department of neurology,Jinan Central Hospital Affiliated to Shandong University from August 2016 to June 2018,were divided into the primary group and the recurrent group.Logistic regression were used to analyze the correlation between various factors and noncardiogenic recurrent cerebral infarction.Results ①There were no statistically significant differences between the two groups in gender,age,smoking and drinking history,homocysteine and uric acid(P>0.05).The incidence of hypertension and diabetes,and the levels of serum retinol binding protein,prealbumin,albumin,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were statistically significant in the recurrent group compared with primary group(P<0.05).②Logistic regression analysis showed that the hypertension,diabetes,prealbumin,low density lipoprotein cholesterol and high density lipoprotein cholesterol were statistically significant(P<0.05).Conclusion In the secondary prevention of cerebral infarction,in addition to the common influencing factors such as hypertension,diabetes and blood lipid,the important protective effect of serum prealbumin on noncardiogenic recurrent cerebral infarction should also be emphasized.
引文
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[10] 宋康平,张玲玲,朱艳,等.血清前白蛋白与脑出血预后的相关性研究[J].中风与神经疾病杂志,2016,33(10):920～922.
[11] 梁宪光,刘恒方,娄渊明.复发性脑梗死血脂变化的临床意义[J].河南实用神经疾病杂志,2003,6(5):4～5.
[12] 尹昌浩,李思瓯,张忠敏.老年人血清胆固醇、低密度脂蛋白、高密度脂蛋白与复发性脑梗死关系的研究[J].医学综述,2012,18(16):2695～2696.
[2] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246～257.
[3] 吴江,贾建平.神经病学[M].第3版,北京:人民卫生出版社,2015:179.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258～273.
[5] 赵红梅,刘文华,王筱萌,等.复发性脑梗死的危险因素及病因学分析[J].中华老年心脑血管病杂志,2013,15(1):42～45.
[6] 王福英,孙培荣,孙丰辉.复发性脑梗死的危险因素分析[J].卒中与神经疾病,2011,18(2):82～85.
[7] Larsen PD,Delallo LJ.Cerebrospinal fluid transthyretin in multiple sclerosis[J].Neurology,1987,37(7):1262～1263.
[8] Zhang H,Shu YZ,Jun J,et al.Dynamics of nutritional status in dyingpatients with acute cerebral infarction incentral China:a preliminary study[J].Neurol Res,2011,33(5):503～507.
[9] Santos SD,Lambertsen KL,Clausen BH,et al.CSF transthyretin neuroprotection in a mouse model of brain ischemia[J].J Neurochem,2010,115(6):1434～1444.
[10] 宋康平,张玲玲,朱艳,等.血清前白蛋白与脑出血预后的相关性研究[J].中风与神经疾病杂志,2016,33(10):920～922.
[11] 梁宪光,刘恒方,娄渊明.复发性脑梗死血脂变化的临床意义[J].河南实用神经疾病杂志,2003,6(5):4～5.
[12] 尹昌浩,李思瓯,张忠敏.老年人血清胆固醇、低密度脂蛋白、高密度脂蛋白与复发性脑梗死关系的研究[J].医学综述,2012,18(16):2695～2696.