摘要
目的探讨各种相关因素对不同类型脑卒中长期预后的影响。方法对1206例不同类型脑卒中的再发及病死率进行回顾性分析,其中男708例,女498例,脑梗死938例,脑出血268例,蛛网膜下腔出血40例。结果多元回归分析表明与脑梗死相关的危险因素有年龄、高血压病、冠心病、糖尿病及吸烟史等。脑卒中发生后的第1个月内再发仅与收缩期血压有关(P<0.05)。脑卒中患者因非脑卒中原因病死者高于脑卒中(P均<0.05)。不同类型脑卒中患者10年中病死率有明显差异,心源性脑栓塞病死率最高,腔隙性脑梗死病死率最低。多元回归分析表明年龄、卒中严重程度、既往卒中史、空腹血糖增高或糖尿病者以及心力衰竭与病死率明显相关(P均<0.05)。结论年龄、卒中严重程度、既往卒中史、心力衰竭、空腹血糖增高及糖尿病均为病死的危险因素,而且年龄、卒中的严重程度、卒中史及收缩压增高也是卒中再发的危险因素。
Objective To determine the long - term outcomes in patients with different types of stroke and explore predictors of recurrent stroke and death. Methods This retrospective study included 1206 patients. The diagnoses were intracerebral hemorrhage （ICH）, cardioembolic cerebral infarction （CE）, lacunar infarction （LI） and athemsclerotic cerebral infarction （ACI）. Results Logistic multiple regression analysis had shown that age, severity of stroke, previous strokes and systolic blood pressure were independent predictors for recurrent stroke. During the observation period, 418 patients suffered from recurrent strokes that could be classified into ACI group, which had 219 cases（52.4% ）;CE, which had 85 cases（20.4% ） ;LI, which had 89 cases（21.3% ） ;and ICH, which had 25 cases（5.9% ）. There were 770（63. 9% ） patients died during the observation period. Besides 211 cases who died of fatal recurrent stroke, 247（32.1% ） patients died of cardiovascular events including myocardial infarction （ 88 ） and heart failure （75）. Furthermore, 108 （43.7 % ） patients died of other causes, such as malignancy（51 ）, uremia（ 11 ） and others diseases（14）. The 30 - day fatality rate was significantly higher among patients with lower consciousness levels（ P 〈 0.05 ）. The mortality rate was statistically significantly higher in patients with increased fasting blood glucose or a history of diabetes than patients withont. Age, severity of stroke, previous strokes and heart failure were all important factors in predicting recurrent stroke. Conclusions This study has shown that age, severity of stroke, previous stroke, heart failure and increased fasting blood glucose or known diabetes are predictors of mortality, whereas age, severity of stroke, previous stroke and systolic blood pressure are predictors of recurrent stroke.
出处
《北京医学》
CAS
2009年第7期385-388,共4页
Beijing Medical Journal
