摘要
目的：了解北京市部分社区缺血性脑卒中患者二级预防现状及再发脑卒中的相关危险因素。方法选择北京市四个社区卫生服务中心，纳入既往确诊为缺血性脑卒中患者326例。收集患者性别、年龄、高血压病史、糖尿病病史、心房颤动（房颤）病史、脑卒中病史、以及抗栓治疗情况，以及患者身高、体重、血压、血糖、总胆固醇等指标。分析缺血性脑卒中患者危险因素的暴露和控制情况以及对再发脑卒中的影响。结果326例患者中男性199例（61.0%），女性127例（39.0%）。高血压、糖尿病、房颤患病率分别为79.8%、20.6%、17.8%。吸烟率、饮酒率、总胆固醇异常率分别为30.2%、22.4%和21.5%。高血压患者血压控制率为15.4%，糖尿病患者血糖控制率为40.2%，阿司匹林服用率为74.2%。再发脑卒中，再发率为15.6%。在调整性别、年龄、超重肥胖、吸烟、抗栓治疗等因素后，血压控制不达标的高血压患者（OR=3.867，95%CI：1.288～11.609）、血糖控制不达标的糖尿病患者（OR=3.288，95%CI：1.458～7.415）、总胆固醇异常者（OR=2.659，95%CI：1.341～5.273）及心房颤动患者（OR=2.181，95%CI：1.063～4.477）再发脑卒中的危险明显增加（P均＜0.05）。结论缺血性脑卒中患者中高血压和糖尿病控制率较低，吸烟、饮酒和总胆固醇异常发生率较高，血压、血糖控制不达标以及总胆固醇异常和房颤病史与再发脑卒中显著相关。
Objective To investigate the current situation of secondary prevention and risk factors related to recurrent stroke in patients with ischemia stroke in some communities of Beijing. Methods The patients with stroke （n=326） were chosen from 4 community health centers, and their data of sex, age, history of hypertension, diabetes, atrial fibrillation （AF） and stroke, antithrombosis treatment, and indexes of height, weight, blood pressure （BP）, blood sugar and total cholesterol （TC） were collected. The exposure and control of stroke risk factors and their influences on recurrent stroke were analyzed. Results Of 326 patients, there were 199 （61.0%） males and 127 （39.0%） females. The prevalence of hypertension, diabetes and AF was, respectively, 79.8%, 20.6%and 17.8%, and rate of smoking, alcohol and abnormal TC was, respectively, 30.2%, 22.4%and 21.5%. The rate of BP control was 15.4%in hypertensive patients, rate of blood sugar control was 40.2%in diabetic patients, and rate of taking aspirin was 74.2%. There were 51 cases （15.6%） with recurrent stroke. After adjusting sex, age, overweight, obesity, smoking and antithrombosis treatment, the risk of recurrent stroke increased significantly in hypertensive patients with poorly BP control （OR=3.867, 95%CI：1.288-11.609）, in diabetic patients with poorly blood sugar control （OR=3.288, 95%CI：1.458-7.415）, in patients with abnormal TC （OR=2.659, 95%CI：1.341-5.273）, and in patients with AF （OR=2.181, 95%CI：1.063-4.477）. Conclusion The rates of BP control and diabetes control are lower, and rates of smoking, alcohol and abnormal TC are higher in the patients with ischemia stroke. Poorly hypertension and blood sugar control, abnormal TC and AF are significantly correlated to stroke recurrence.
出处
《中国循证心血管医学杂志》
2014年第1期80-83,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
