北京市社区卒中后三个月的残疾情况及其影响因素

目的 调查北京1个社区首发和复发卒中患者3个月内的残疾情况及其影响因素.方法 根据北京城区1个社区的卒中注册登记研究,对2007-2008年监测到的首发和复发性卒中患者,采用Barthel指数（BI）量表进行残疾评估,定义BI＜ 95为残疾,BI＜ 50为重度残疾、BI 50 ～ 94为轻度残疾. 结果 ①共登记急性发病3个月时,完成BI评估的299例患者.总残疾率为40.1％（120/299）,轻度和重度残疾分别占55％ （66/120）和45％（54/120）.卒中残疾率随年龄增加而上升,＜60岁、60 ～ 69岁、70 ～ 79岁、≥80岁卒中患者的残疾率分别为28.2％、27.4％、48.5％、62.1％（趋势检验x2=15.791,P＜0.000 1）.接受降压治疗的卒中患者3个月内残疾率低于未接受降压治疗者（34.9％比51.4％,P＜ 0.05）.②多因素Logistic回归分析显示,年龄增加是卒中后残疾的独立危险因素（OR=1.05,95％ CI：1.02～1.07）.降压治疗是合并高血压病史的卒中患者无残疾的独立保护因素（OR=0.40,95％ CI：0.22 ～0.75）. 结论 卒中后残疾为卒中常见并发症.在社区首发和复发卒中残疾患者中,重度残疾占有很高的比例.年龄增加是卒中后残疾的独立危险因素,降压治疗是合并高血压病史的卒中患者无残疾的独立保护因素.

Disability and its influencing factors at three months after stroke in a Beijing community

Abstract： Objective To investigate the disability and its influencing factors at 3 months after firstever and recurrent stroke in a Beijing community. Methods The disability assessment in patients with first-ever and recurrent stroke monitored from 2007 to 2008 were performed according to the stroke registry study in a geijing community. Barthel index （BI） scores were used to assess the disabilities. BI 〈95 was defined as disability, BI 〈50 was defined as severe disability, and BI =50 to 94 was defined as mild disability. Results ①A total of 299 patients with acute stroke onset who had completed assessment at 3 months were registered. The total disability rate was 40.1% （120/299）. The mild and severe disability rates accounted for 55% （66/120） and 45% （55/120） , respectively. The stroke disability rate increased with age. The disability rates of the patients with 〈 60, 60 to 69, 70 to 79, and ≥80 years were 28.2% ,27.4% , 48.5% , and 62.1% , respectively （ Trend X2 = 15. 791 , P 〈 0. 000 1 ）. The disability rate in stroke patients receiving antihypertensive therapy within 3 months was lower than those without receiving antihypertenslve therapy （34.9% vs. 51.4% , P 〈 0.05）. ②Multivariate logistic regression analysis showed that the increasing age was an independent risk factor for post-stroke disability （ OR = 1.05, 95% CI 1.02 to 1.07）. Antihypertensive therapy was an independent protective factor for without disability in stroke patients with a history of hypertension （ OR = 0.40, 95% CI 0. 22 to 0. 75）. Conclusions Post-stroke disability is a common complication. In the disability patients with the first-ever and recurrent stroke in the community, severe disability accounts for a high proportion. The increasing age is an independent risk factor for post-stroke disability. Antihypertensive therapy is an independent protective factor for without disability in stroke patients with a history of hypertension.