缺血性卒中再发危险因素分析

目的 探讨缺血性卒中再发的危险因素。方法 收集我院急性缺血性卒中病例195例，收集患者资料：年龄、既往吸烟、高血压病、糖尿病史，入院后检测血脂、同型半胱氨酸、纤维蛋白原（fibrinogen，Fg）、超敏C反应蛋白（high sensitive C-reactive protein，hsC-RP）、颈动脉超声等。对病例进行随访2年，患者分为缺血性卒中再发组和缺血性卒中无再发组2组，分析以上因素在两组间的差异。结果 195例患者入选，3例因其他系统疾病死亡失访，192例参加随访的缺血性卒中病例中52例再发，再发率27.1％。单因素分析显示，缺血性卒中再发组的年龄、hsC-RP、Fg水平显著高于缺血性卒中无再发组；糖尿病、高血压病、颈动脉斑块发生率也明显高于缺血性卒中无再发组。多因素分析显示，hsC-RP>3mg/L[比值比（odds ratio，OR）=2.72；95%置信区间（confidence interval，CI）1.35～5.46；P=0.005）、Fg>4g/L（OR=2.31；95%CI 1.16～4.58；P=0.017）与缺血性卒中再发独立相关。结论 缺血性卒中急性期hsC-RP、Fg增高是缺血性卒中再发的独立危险因素。

Analysis of Risk Factors of Ischemic Stroke Recurrence

Objective To investigate the risk factors and mechanism ofischemic stroke recurrence. Methods Data of 195 patients with ischemic stroke in our hospital were collected. Including age, smoking, history of hypertension or diabetes, the serum levels of lipid, homocysteic acid, fibrinogen, and high sensitivity C-reactive protein （hsC-RP）, ultrasonic of the carotid arteries. We follow up the patients for 2 years. Patients were divided into 2 groups： ischemic stroke recurrence group and non-recurrence group. We analyzed the different of risk factors between these 2 groups. Results One hundred and ninety-five cases were included in the present study, 3 of them died of other system disease, 52 of 192 patients（27.1%）had ischemic stroke recurrence. Single factor analysis showed that age, level of hsC-RP and fibrinogen were higher in the ischemic stroke recurrence group than those in non-recurrence group; History of hypertension or diabetes, and carotid plaque were more frequent in the ischemic stroke recurrence group. Logistic regression analysis showed that： hsC-RP〉3mg/L（OR 2.72; 95%CI 1.35-5.46;P=0.005）and Fg〉4g/L（OR 2.31; 95%CI 1.16-4.58;P=0.017）were the independent predictors ofischemic stroke recurrence. Conclusion Higher hsC-RP and fibrinogen concentration in acute phase after ischemic stroke are the independent predictors of ischemic stroke recurrence.