脑梗死近期再发危险因素研究

目的 探讨脑梗死近期再发的相关危险因素。方法 对85例首发脑梗死患者的年龄、性别、血压、血糖、甘油三酯（TG）、总胆固醇（TC）、凝血功能、房颤、烟酒摄入量及体质指标进行为期2a的定期复查。对脑梗死近期再发与非再发患者的各指标进行比较,并利用回归方程进行预测。结果 在有效随访的85例患者中,出现脑梗死近期再发者31例,未再发者54例。单因素分析显示,血压、血糖、TG、TC、纤维蛋白原、房颤、吸烟、嗜酒和肥胖与脑梗死近期再发相关（P〈0.05）。Logistic回归分析显示,血压、血糖和TC是脑梗死近期再发的独立危险因素,OR（95%CI）分别为1.087（1.011～1.170）,1.700（1.082～2.669）,3.841（1.188～12.415）。回归方程为P（脑梗死近期再发）=1/〔1＋e-（-15.675＋0.084血压＋0.530血糖＋1.346胆固醇）〕,有统计学意义（χ^26.066,P=0.014,r2=0.574）。用Logistic方程预测显示,在54例病情稳定未再发的病例中有49例为稳定,正确率90.7%;在31例再发病例中有26例为再发,正确率为83.9%;总符合率为88.2%。结论 血压、血糖和血清总TC作为脑梗死近期再发的独立预测指标。

Risk Factors for Short-term Recurrence of Cerebral Infarction

Objective To analyze the risk factors for short-term recurrence of cerebral infarction. Methods The age, gender, blood pressure, blood sugar, serum triglyceride, serum cholesterol, blood coagulation, atrial fibrillation, intaking of tobacco and alcohols, and body mass index （BMI） were detected in the patients with initial cerebral infarction. During the follow-up of 2 years, they were observed on the factors that might be associated with the recurrence of cerebral infarction. Results By single factor analysis, hypertension, hyperglycemia, high blood lipid, high serum cholesterol, high blood fibrinogen, atrial fibrillation, heavy smoking, excessive drinking, obesity were significantly associated with the recurrence of cerebral infarction in the two-years follow-up（P〈0.05）. By multivariate logistic regression analysis, hypertension, hyperglycemia and high serum cholesterol were independent risk factors （Regression eoefficient 0.084, 0.530, 1.346, respectively, all P〈0.05）. Conclusion Hypertension, hyperglycemia, high serum cholesterol can serve as the independent predictive indexes of the recurrence of cerebral infarction within 2 years.