基于CISS分型的复发性脑梗死的高危因素及其与亚型的相关性

目的 分析基于中国缺血性脑卒中亚型(CISS)分型的脑梗死1年内复发的危险因素及其与各亚型的相关性,为临床干预提供依据.方法 收集1 446例脑梗死及随访1年内复发患者,进行CISS分型,同期调查并分析各亚型中危险因素的分布状况.运用多元回归方法分析不同脑梗死亚型患者各危险因素与1年内梗死复发的独立相关性.结果 1 446例患者中,其中大动脉粥样硬化(LAA)亚型741例, 穿支动脉病变(PAD)亚型501例,心源性栓塞(CS)亚型119例,病因不明(UE)亚型55例,其他(OE)亚型30例.1年内梗死复发125例,其中LAA亚型61例,PAD亚型38例,CS亚型21例,UE亚型5例,OE亚型0例.多元回归分析显示,颈动脉中度狭窄、颈动脉重度狭窄与LAA亚型1年内梗死复发独立相关(OR=6.178、9.016,95% CI:2.262~11.749、3.023~15.172,P=0.012、0.004);高血压与PAD亚型1年内梗死复发独立相关(OR=1.786,95% CI:1.102~2.942,P=0.013);年龄、心房纤颤与CS亚型1年内脑梗死复发独立相关(OR=1.031、6.179,95% CI:1.012~1.051、1.045~35.128,P=0.003、0.032).结论 颈动脉中重度狭窄是LAA亚型复发的独立危险因素,高血压是PAD亚型复发的独立危险因素,年龄、心房纤颤是CS亚型复发的独立危险因素.

The correlation between risk factors and subtype in recurrentcerebral infarction patients based on CISS classification

Objective To analyze the correlation between the risk factors and the subtype in recurrent cerebral infarction patients within 1 year based on CISS classification, and to provide the basis for clinical intervention.Methods A total of 1 446 patients with cerebral infarction were enrolled in this study.The distribution of risk factors in each subtype was investigated and analyzed on the basis of CISS for these patients.Multiple regression analysis was used to analyze the association between risk factors and stroke recurrence within 1 year in ischemic stroke patients with different subtype.Results Among the 1 446 patients, 741 were LAA subtype, 501 were PAD subtype, 119 were CS subtype, 55 were subtype UE, and 30 were OE subtype.125 patients had stroke recurrence within 1 year, including 61 cases of LAA subtype, 38 cases of PAD subtype, 21 cases of CS subtype, 5 cases of UE subtype.Multivariate regression analysis showed that moderate stenosis of carotid artery and severe stenosis of carotid artery were associated with stroke recurrence in patients with LAA subtype(OR=6.178,9.016,95% CI:2.262~11.749,3.023~15.172,P=0.012,0.004).Hypertension(OR=1.786,95% CI:1.102~2.942,P=0.013) was associated with stroke recurrence in patents with PAD subtype.Age and atrial fibrillation were associated with recurrence in patients with CS subtype(OR=1.031,6.179,95% CI:1.012~1.051,1.045~35.128,P=0.003,0.032).Conclusion Moderate and severe stenosis of carotid artery are independent risk factors for LAA subtype recurrence.Hypertension is an independent risk factor for PAD subtype recurrence.Age and atrial fibrillation are independent risk factors for recurrence of CS subtype.