脑梗死患者复发的危险因素及二级预防依从性对其的作用

目的 探讨脑梗死复发的危险因素以及对危险因素进行二级预防,探讨依从性对复发率的作用.方法 对1年内发病的269例脑梗死患者完成随访,收集基本信息（包括性别、年龄、体重指数等）、改良Rankin量表（mRS）评分、Essen卒中风险评分量表（ESRS）评分（高血压病史、糖尿病史、心脏病史、吸烟史等）、目前预防性治疗（口服抗血小板聚集药、降压药、降糖药、降脂药、限盐等）等方面的数据,根据1年内有无复发,将本组病例分为复发组（73例）和无复发组（1%例）,分析脑梗死可能的复发危险因素,并分析各危险因素二级预防依从性对复发率的影响.结果 ①复发组患者的高血压病、糖尿病、高脂血症及吸烟者的比例均高于无复发组,差异有统计学意义,均P〈0.01.两组患者的心脏病史比例近似,差异无统计学意义,P〉0.05.②多元Logistic回归分析显示,脑梗死复发的危险因素包括高血压病、糖尿病、吸烟、高脂血症.③口服阿司匹林患者的复发率（24.42%）低于未服用者（38.46%）,χ2=4.181,P 〈0.05.④按有高血压病、糖尿病、高脂血症、吸烟等病史的人数计算,采取相应二级预防干预措施者复发率均低于未采取干预措施者,差异有统计学意义,均P 〈0.05.结论 脑梗死患者复发的危险因素包括高血压病、糖尿病、吸烟、高脂血症,其良好的二级预防依从性有利于降低脑梗死的复发率.

Risk factors for recurrence in patients with cerebral infarction and the role of secondary prevention compliance

Objective To investigate the risk factors for recurrence of cerebral infarction and the role of secondary prevention compliance. Methods Two hundred sixty-nine patients with cerebral infarction were completed the follow-up study for 1 year after onset. The data such as basic information （ including sex, age, and body weight index）, modified Rankin scale （mRS） score, Essen stroke risk scale （ESRS） score （histories of hypertension, diabetes, heart disease, and smoking） , and present prophylactic treatment （oral anti-platelet aggregation drugs, antihypertensive drugs, hypoglycemic agents, lipid-lowering drugs, and salt restriction） were collected. The patients were divided into a recurrent group （n = 73 ） and a non-recurrence of group （n = 196） according to whether they had recurrence or not within 1 year. The possible risk factors for recurrence of cerebral infarction and the role of all risk factors for secondary prevention compliance were analyzed. Results （1）The proportions of hypertension, diabetes, hyperlipidemia and smoking in the recurrent group was higher than those in the non-recurrent group. The differences were statistically significant （ all P 〈 0.01 ）. （2）A muhiple logistic regression analysis showed that the risk factors for recurrent cerebral infarction included hypertension, diabetes, smoking, and hyperlipidemia. （3）The recurrence rate （24.42%） in patients who took aspirin was lower than that did not （38.46%） （X2 =4. 181, P 〈 0.05 ）. （4）According to the calculation of the numbers of patients with the histories of hypertension, diabetes, hyper/ipidemia, and smoking, the recurrence rate in those who took appropriate secondary preven- tion interventions was lower than those who did not. The differences were statistically significant （ all P 〈0. 05 ）. Conclusion The recurrent risk factors of recurrence in patients with cerebral infarction include hypertension, diabetes, smoking, and hyperlipidemia. The favorable secondary prevention compliance is helpful to reduce the recurrence rate of cerebral infarction.