缺血性脑卒中患者发病后不同时期生活质量的影响因素研究

背景　随着我国医疗水平的提高，患者越来越关注自身生活质量。改善患者的生活质量是处理“人民日益增长的美好生活需要和不平衡不充分的发展之间的矛盾”的方法之一。目的　了解不同时期缺血性脑卒中患者生活质量的现状，分析其相关因素，为改善患者生活质量提供参考依据。方法　选取2017年6月至2019年9月于石河子大学医学院第一附属医院康复医学科、神经内科就诊的缺血性脑卒中患者120例，收集脑卒中危险因素，并在入院后3~5 d、发病后1个月、发病后3个月采用脑卒中专用生活质量量表（SS-QOL）评估患者的生活质量，采用单因素分析、多元线性回归分析探究发病后缺血性脑卒中患者不同时期生活质量的影响因素。结果　多元线性回归分析结果显示：年龄、医保类型、体质指数（BMI）、吸烟史/饮酒史、糖尿病、高脂血症、改良Rankin量表（MRS）评分、治疗方案是入院后3~5 d缺血性脑卒中患者生活质量的独立影响因素（P<0.05）；年龄、医保类型、BMI、吸烟史/饮酒史、高血压、糖尿病、高同型半胱氨酸血症是发病后1个月缺血性脑卒中患者生活质量的独立影响因素（P<0.05）；年龄、文化程度、医保类型、BMI、吸烟史/饮酒史、高血压、糖尿病、高同型半胱氨酸血症、治疗方案是发病后3个月缺血性脑卒中患者生活质量的独立影响因素（P<0.05）。结论　不同时期缺血性脑卒中患者生活质量的影响因素不同，只有在不同时期关注不同的影响因素才能更好地做到患者全病程管理。

Factors Associated with Quality of Life in Patients with Ischemic Stroke at Different Periods

Background　Patients are showing increasing care about quality of life as healthcare advances. Improving quality of life is a means for addressing the contradiction between increasing needs for a better life and imbalanced or inadequate socioeconomic development. Objective　To investigate the status of quality of life and associated factors in patients with ischemic stroke at different periods，providing a basis for improving quality of life of this population. Methods　One hundred and twenty patients with ischemic stroke were recruited from Department of Rehabilitation Medicine and Department of Neurology，First Affiliated Hospital，School of Medicine，Shihezi University from June 2017 to September 2019. Risk factors of stroke，quality of life assessed using the Stroke-specific Quality of Life Scale （SS-QOL） within three to five days of admission，one and three months after onset were collected. Univariate analysis and multiple linear regression analysis were used to investigate the factors influencing quality of life at the above-mentioned three periods. Results　Multiple linear regression analysis revealed that older age，having no health insurance，higher body mass index （BMI），smoking/drinking history，diabetes，hyperlipidemia，higher Modified Rankin Scale score and conservative treatment were independent risk factors of poor quality of life within three to five days of admission （P<0.05）；older age，having no health insurance，higher BMI，smoking/drinking history，hypertension，diabetes，and hyperhomocysteinemia were independent risk factors for poor quality of life at one month after admission （P<0.05）；older age，lower education level，having no health insurance，higher BMI，smoking/drinking history，hypertension，diabetes，hyperhomocysteinemia and conservative treatment were independent risk factors of poor quality of life at three months after admission （P<0.05）. Conclusion　The factors affecting the quality of life of stroke survivors in different periods are different. Only by paying attention to different influencing factors in different periods can stroke patients be better managed in the whole course of disease.