摘要
目的:评估国人缺血性脑卒中再发的主要危险因素,以期为缺血性脑卒中的二级预防提供参考。方法:提取在南京卒中注册项目中登记的缺血性脑卒中随访2年的患者,对脑卒中的主要可控危险因素进行分层:无、有但已控制和有但未控制。采用Cox比例危险模型评估脑卒中再发的风险。结果:登记患者第1年的脑卒中总体再发率为11.2%。在分析的危险因素中,高血压、心房纤颤和吸烟对脑卒中再发的影响显著。高血压患者有效控制血压、心房纤颤患者使用抗凝药均可使其再发危险减半(P<0.001)。停止吸烟1年以上可使脑卒中再发的危险比率(HR)从1.71降至1.39(P<0.05)。糖尿病患者控制血糖水平对于脑卒中再发危险的影响无显著差异(HR为1.69和1.64,P>0.05)。结论:国人缺血性脑卒中的再发率稍高于西方人群的水平。控制高血压、心房纤颤患者使用抗凝药、戒烟可有效降低脑卒中复发率。
Objective： Data on the recurrence of ischemic stroke in the Chinese population are rarely re- ported. This study was designed to analyze the determinants of its recurrence in a cohort of Chinese patients. Methods： The subjects were ischemic stroke patients registered in Nanjing Stroke Registry Program and followed up for 2 years. Modifiable risk factors for stroke were identified and stratified into 3 levels： no, controlled and uncontrolled. The Cox proportional hazard model was used to detect the factors of stroke recurrence. Results ： The first-year recurrence rate of ischemic stroke was 11.2% in the registered patients. Hypertension, atrial fibrillation （AF） and smoking were associated with the increased risk of recurrence. The hazard ratio （HR） of recurrence was halved in the hypertension patients with their blood pressure effectively controlled and in the AF patients treated with anticoagulant drug （P 〈 0.01 ） and reduced from 1.71 to 1.39 in those who ceased smoking for over a year （P 〈 0.05 ）, but had no significant difference between the diabetic patients who had controlled the blood sugar level and those who had not （ HR： 1.69 vs 1.64, P 〉 0.05 ）. Conclusion ： The recurrence rate of ischemic stroke is a little higher in Chinese patients than in Western populations, but it can be effectively reduced by control of high blood pressure, anticoagulant medication for AF and cessation from smoking.
出处
《医学研究生学报》
CAS
2008年第9期962-965,共4页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金资助项目(批准号:2006024)
关键词
中国人
再发
危险因素
脑卒中
Chinese
Recurrence
Risk factor
Ischemic stroke
