脑卒中病人发生残疾的影响因素分析

  目的  分析辽宁农村地区脑卒中患者残障现状及其相关危险因素，为脑卒中后减少残障发生提供理论依据。  方法  2017年9月至2018年5月按照分层整群随机抽样方法在辽宁省农村地区随机选取四个县19个村庄，对年龄 ≥ 40岁的731例脑卒中患者进行残障现状及其相关危险因素调查，mRS评分3分及以上定义为残障。  结果  辽宁省农村40岁及以上脑卒中患者残障率为13.41 %，缺血性卒中和出血性卒中分别为11.96 % 和21.86 %。男性缺血性卒中残障率随着年龄增加而升高，男性缺血性卒中mRS平均分高于女性。老龄化和性别是卒中后残障的主要危险因素。多因素logistic回归分析显示，男性（OR = 1.90，95 % CI = 1.18～3.05）、家庭年均总收入高（OR = 0.39，95 % CI = 0.18～0.83）、超重或肥胖（OR = 0.47，95 % CI = 0.30～0.73）、吸烟（OR = 0.44，95 % CI = 0.24～0.80）是患脑卒中残障的影响因素。  结论  辽宁省农村地区40岁以上人群脑卒中后残障率高，亟待早期发现并控制相关不良影响因素，采取有效且针对性强的措施，以减少卒中后残障发生概率，综合提高卒中患者的生活质量。

Projections of global mortality and burden of disease from 2002 to 2030

  Objective  To explore prevalence and risk factors of disability among stroke patients in rural areas of Liaoning province and to provide evidences for reducing the incidence of disability after stroke.  Methods  Using stratified cluster random sampling, we conducted a survey in 19 administrative villages of 4 counties in different geographical regions across Liaoning province from September 2017 to May 2018. Among the identified 731 stroke patients aged 40 years, we carried out questionnaire interview, physical examination and laboratory test and disability status of the patients was assessed with modified Rankin scale (mRS).  Results  The prevalence rate of disability was 13.41% for all the patients and the rate was 11.96% and 21.86% for ischemic and hemorrhagic stroke patients. Among the male patients, the prevalence rate of disability rate of the male ischemic stroke increased with the increment of age and the average score of mRS of the male ischemic stroke patients was higher than that of the female patients. Aging and gender were main risk factors for post-stroke disability for the patients. Multivariate logistic regression analysis revealed following significant impact factors of disability of the stroke patients: male gender (odds ratio [OR] = 1.90, 95% confidence interval [95% CI]: 1.18 – 3.05), high average annual family income (OR = 0.39, 95% CI: 0.18 – 0.83), overweight or obesity (OR = 0.47, 95% CI: 0.30 – 0.73), and smoking (OR = 0.44, 95% CI: 0.24 – 0.80).  Conclusion  The prevalence of disability is high among stroke patients aged 40 years and over in rural areas of Liaoning province, suggesting that effective and specific intervention measures need to be implemented urgently among the patients.