摘要
目的：探讨急性脑梗死患者卒中后6个月残疾的危险因素。方法前瞻性收集2010年8月至2014年8月在济南军区总医院神经内科住院治疗的1137例急性脑梗死患者，其中女性424例；牛津郡社区卒中计划分型完全前循环型275例，部分前循环型377例，后循环型305例，腔隙性脑梗死型180例。记录其年龄、性别、美国国立卫生研究院卒中量表（ NIHSS）评分等基线资料。于病后6个月通过电话随访，采用改良Rankin量表（ mRS）对其预后进行评价（ mRS≤2分为预后良好，2＜mRS≤5分为残疾）。用双元回归分析、多元回归分析法分析性别与残疾的关系及预后相关因素。结果123例急性脑梗死患者病死，剩余的1014例中，376例女性患者残疾127例，638例男性残疾156例；女性患者残疾的比例（33．8％）高于男性（24．5％），差异有统计学意义（χ2＝9．86，P ＝0．002）。单因素相关性分析示女性（P＝0．002）、年龄≥73岁（P＝0．000）、NIHSS≥8（P＝0．000）、心肌梗死（P＝0．001）、心力衰竭（P＝0．000）、糖尿病（P＝0．002）、心房颤动（P＝0．000）、高脂血症（P＝0．003）、复发脑梗死（P＝0．000）、吸烟嗜好（P＝0．003）、饮酒嗜好（P＝0．004）、腔隙性脑梗死（P＝0．000）与急性脑梗死患者发病6个月残疾显著相关。多因素分析示女性[1．681（95％CI：1．183～2．390，P＝0．004）]、年龄≥73岁[3．955（95％CI：2．708～5．776），P ＝0．000]、NIHSS≥8[7．473（95％CI：5．154～10．837），P＝0．000]、复发性脑梗死[3．149（95％CI：2．150～4．614），P＝0．000]、心房颤动[2．558（95％CI：1．465～4．466），P＝0．001]和糖尿病[2．010（95％CI：1．415～2．855），P＝0．000]是急性脑梗死患者发病6个月残疾的独立危险因素。而腔隙性脑梗死[0．226，（95％CI：0．112～0．456）， P＝0．000]是急性脑梗死�
Objective To analyze the risk factors of post-stroke disability in patients with acute cerebral infarction.Methods Total 1 137 consecutive patients with acute cerebral infarction admitted in Department of Neurology, General Hospital of Jinan Military Region, were prospectively recruited from August 2010 to August 2014.According to Oxfordshire Community Stroke Project（OCSP）, 275 patients were classified as total anterior circulation infarction, 377 as partial anterior circulation infarction,305 as posterior circulation infarction and 180 as lacunar infarction.The baseline data including age, gender, National Institute of Health Stroke Scale （ NIHSS） score were recorded.Recovery was assessed by modified Rankin Scale （ mRS） 6 months after stroke by telephone interview （ mRS≤2：good prognosis, 2＆lt;mRS≤5：disability） .Univariate and multivariate regression were used to analyze risk factors of disability 6 months after disease onset.Results During the study period 123 patients died.Among remaining 1 014 patients, 638 were males and 376 were females;and 283 patients were disabled after stroke, including 156 males and 127 females.The disability rate in females were significantly higher than that in males（33.8%vs.24.5%,χ2 =9.86, P=0.002）.Univariate analysis also showed that age≥73 years（P=0.000）, NIHSS score≥8 （P=0.000）, myocardial infarction（P=0.001）, congestive heart failure（P=0.000）, diabetes（P=0.002）, artrial fibrilation（P=0.000）, hyperlipidemia（P =0.003）, recurrent cerebral infarction（P =0.000）, smoking（P =0.003）, alcohol drinking（P =0.004） and lacunar infarction（P =0.000） were correlated with disability.Multivariate regression analysis showed that female sex （ OR=1.681, 95%CI：1.183-2.390, P=0.004）, age≥73 years （OR=3.955, 95%CI：2.708-5.776, P=0.000）, NIHSS score≥8 （OR=7.473, 95%CI：5.154-10.837, P=0.000）, recurrent cerebral infarction （OR=3.149, 95%CI：2.150 -4.614, P =0.000）, atrial fibrillation （ OR =2.558, 95
出处
《中华全科医师杂志》
2016年第10期765-769,共5页
Chinese Journal of General Practitioners
关键词
脑梗塞
性别因素
残疾
Brain infarction
Sex factors
Disbility
