脑血管意外预后危险因素的病例—对照研究

目的 为探讨影响脑血管意外预后的有关因素,以住院病死病例作为病例组;存活病人为对照组。对华西医科大学附属第一医院神经内科的1990年至1996年297例患者作了回顾性的分析和研究。方法 全部病例资料应用国际临床流行病脑卒中协作组调查表,逐项记录,特别是对影响预后的有关重要因素如:病程、病情程度、神智状态、病型、年龄、合并症、并存症以及即往史和住院治疗等作了详细统计。并用双输法建立相关的数据库,资料分析处理采用x~2检验,非条件Logistic多元回归分析,并在STATA 5.0软件包上运行。结果 全部297例患者中,死亡者31例(10.4％),存活者266例。脑梗塞型179例(60％)。病例组中神智和语言障碍程度明显严重于对照组,并发高血压的比例亦高;但糖尿病及心脏病变致心律失常者,两组无差异。多因素分析链激酶类药和中西结合治疗有保护性作用(OR<1)。结论 提示住院患者脑卒中的病死率与年龄、梗塞类型、精神状态、高血压等有关。在常规治疗的基础上,中西医结合用药及溶栓抗凝药STK疗效较好。

Case-control study on risk factors of prognosis in stroke

Objective In order to investigate the treatment effects and related risk factors of prognosis, 297 patients with cerebrovascular disease were analyzed and according to the patients' state, they were divided into dead group and alive group (control). Methods The questionnaire of INCLEN multicenter aollabo-ration was used to collect related information such as course of disease, mental state, stroke type, age, complication and treatment in hospital. Double-input method was used 'in data management. Chi-square test and non-conditional logistic regression was used in data analysis and all procedures were run on STATA 5. 0 package.Results The fatality rate of hospital is 10. 4%(31/297),and 60%(197/297) patients belong to infarct type. Death group had serious mental disorder,more swallowing difficulty and complicated hypertension (P<0. 05) ,while there are no difference in complicated diabetes and atrial fibrillation. STK and traditional-chinese medicine have significant effect in treatment. Conclusion The results show that fatality rate of patients are related with age, stroke type, mental disorder, complicated hypertension. STK and traditional-chinese medicine plus routine treatment are helpful in improvement of prognosis.