超高龄大动脉粥样硬化性卒中患者脑梗死复发的 危险因素分析

目的:探讨超高龄大动脉粥样硬化性卒中(LAA)患者90 d及1年内复发的危险因素。方法:超高龄(≥80岁)LAA患者182例纳入研究。根据发病90 d和1年内有无复发进行分组,采用单因素分析法及多因素Logistic回归分析法分析脑梗死复发的危险因素。结果:发病90 d内,不稳定斑块(OR=2.015,95%CI1.132-3.011,P=0.024)是超高龄LAA患者复发的危险因素。发病1年内,糖尿病(OR=3.351,95%CI 1.724-7.816,P=0.007)、颈动脉狭窄程度(OR=2.035,95%CI 1.140-3.118,P=0.021)及斑块性质(OR=2.205,95%CI1.545-4.770,P=0.013)是超高龄LAA患者复发的影响因素。结论:对于超高龄LAA患者,不稳定斑块是早期复发的危险因素,而糖尿病、颈动脉狭窄程度和斑块性质均与远期复发相关。

Risk Factors of Recurrence of Ischemic Stroke in Extreme Elderly Patients with Large Artery Atherosclerosis

To investigate the risk factors of recurrence of ischemic stroke in extreme elderly patients with large artery atherosclerosis (LAA). Methods: One hundred and eighty-two extreme elderly patients with acute ischemic stroke (LAA) were included in the study. According to the follow-up results of 90 days and 1 year, these patients were divided into the recurrent LAA group and the control group, respectively. The risk factors of recurrence of ischemic stroke were analyzed by univariate analysis and Multiariable logistic regression analysis. Results: Within 90 days, unstable plaque (OR=2.015, 95%CI 1.132-3.011, P=0.024) was associated with recurrence of ischemic stroke for extreme elderly patients with LAA. Within one year, diabetes (OR=3.351, 95%CI 1.724-7.816, P=0.007), carotid stenosis severity (OR=2.035, 95%CI I 1.140-3.118, P=0.021) and character of atherosclerotic plaques (OR=2.205, 95%CI 1.545-4.770, P=0.013) were associated with recurrence of ischemic stroke for extreme elderly patients with LAA. Conclusion: For extreme elderly patients with LAA, unstable plaque was the risk factor of early recurrence of ischemic stroke. Diabetes, carotid stenosis severity and character of atherosclerotic plaques were associated with long-term recurrence of ischemic stroke.