近期感染作为缺血性脑卒中危险因素的调查

目的:研究近期感染可否作为缺血性脑卒中的独立危险因素。方法:做回顾性病例对照研究,选择我院2003年1月~2005年12月住院的缺血性脑卒中656例为脑卒中病例组(病例组),同期住院的非脑卒中656例为对照组,就两组近期感染发生的时间、感染病种、病前危险因素进行比较分析。结果:病例组发病前1周、2~4周及4周感染率分别为17.1%、18.3%、18.9%,对照组的感染率分别为1.7%、1.8%、1.8%,两组比较差异有非常显著的统计学意义(P<0.01);两组感染病种均以呼吸系统感染居多,其中病例组51~60岁、61~70岁、71~80岁年龄段感染率分别为25.49%、15.06%、17.96%,对照组感染率分别为5.88%、1.93%、8.16%,两组比较差异具有非常显著的统计学意义(P<0.01);当原有高血压病、糖尿病、冠心病、房颤、TIA史存在时,在分组资料非条件Logistic回归模型中近期感染是一独立的危险因素(OR值1.630;95%C I 1.068~2.489)。结论:发病前4周,尤其是1周感染是缺血性脑卒中的独立危险因素,呼吸系统感染与缺血性脑卒中发作的关系最为密切。

The Investigation of Infection as a Risk Factor for Cerebrovascular Ischemia

Objective: To observe the recent infection is the independent risk factor of ischemic stroke.Methods:We performed a retrospective case-control study in 656 patients with acute cerebrovascular ischemia(patient group)and 656 people were randomly selected as control subjects matched for gender and age.The patients and control subjects were the hospitalized patients from 01/2003 to 12/2005.We analyzed and compared the onset time of infection,the kind of infection,predisposed risk factors in both groups.Results:the infection rate in patient group before ictus was 17.1% within 1 week,18.3%,within 2 to 4 weeks and 18.9%within 4 week.The infection rate in control group before ictus was 1.7% within 1 week,1.8%,within 2 to 4 weeks and 1.8%within 4 week,there were significant difference(P<0.01).Respiratory tract infections were most common in both groups.In patient group,the infection rates were respectively 25.4% in patients aged 51 to 60,15.06% in patients aged 61 to 70 years and 17.96% in patients aged 71 to 80 years,in control group,they were respectively 5.88%,1.93% and 8.16%,there were significant difference(P<0.01).Infection remained a significant risk factor when previous hypertension,diabetes mellitus,coronary heart disease,transient ischemic attack,cardiac fibrillation were included as covariates in a nonconditional logistic modle.Conclusion:Infection within 4 weeks especially 1week before ictus may be an independent risk factor for cerebrovascular ischemia.Respiratory system infection is mainly relevant to cerebrovascular ischemia.