老年缺血性脑卒中患者预后及其影响因素的研究

目的观察老年缺血性脑卒中患者预后情况并对影响因素进行分析。方法回顾性收集2002年1月~2005年6月第四军医大学西京医院神经内科确诊的连续性缺血性脑卒中患者846例作为研究对象,采用电话、信访等方式随访,改良Rankin评分为结局指标,2006年1月完成随访工作,最终纳入分析的患者485例。对影响预后因素进行单因素和多元逐步回归分析。结果485例患者中,随访时间最短1天,最长47个月,失访37例(7.6%)。单因素及多元逐步回归分析显示,预后不良与高龄、美国国立卫生院脑卒中量表(NIHSS)评分高、有脑卒中史及低文化程度有关,其中NIHSS评分对预后不良的影响最大。结论NIHSS评分高、高龄、低文化程度、有脑卒中史是预后不良的主要影响因素。

A study of prognosis and influential factors of ischemic stroke in the elderly

Objective To observe the prognosis and to analyze the influential factors of ischemic stroke in elderly ischemic stroke patients.Methods 846 successive elderly ischemic stroke cases were retrospectively collected in the neurology department of Xijing Hospital of the Fourth Military Medical University from January 2002 to June 2005.The patients were followed up through phone or mail and the modified Rankin Scale(mRS) score was used as the index of primary outcome.The follow-up was finished in January 2006.The influential factors were analyzed by monovariate and multivariate stepwise regression analysis.Results 846 successive cases were collected,281 of whom did not met the inclusion criteria and 43 were excluded.The shortest follow-up time was 1 day and the longest was 47 months.Thirty-seven cases were lost to follow-up,the lost rate was 7.6%.Thus,the final number was 485.Monovariate and multivariate stepwise regression analysis showed that unfavourable prognosis was associated with advanced age,high National Institutes of Health Stroke Scale(NIHSS) score,positive stroke history and low educational level.Among these,NIHSS score was the most important factor.Conclusion The NIHSS score,age,educational level and the stroke history are the major factors influencing the prognosis of the elderly with ischemic stroke.