脑梗死复发的相关因素分析

目的探讨脑梗死复发的相关因素及二级预防方法.方法回顾性分析了资料完整的261例脑梗死患者,采用Logistic回归模型方法及x2检验方法.结果首次发病年龄、性别、既往短暂性脑缺血发作史、原发性高血压史、糖尿病史、高脂血症、服抗凝药及嗜烟与脑梗死复发相关(P值均小于0.05).年龄＜45岁的脑梗死患者复发高于≥45岁的脑梗死患者(P＜0.005).嗜烟≥10年的脑梗死患者复发高于嗜烟＜10年的脑梗死患者(P＜0.001).服抗凝药组(76例)与未服抗凝药组(45例)复发率比较差异有显著性意义(P＜0.01).服抗凝药≥2年的患者与服抗凝药＜2年的患者复发率比较差异有显著性意义(P＜0.01).结论首次发病年龄、短暂性脑缺血发作史、原发性高血压史、糖尿病史、高脂血症及嗜烟是脑梗死复发的危险因素,年龄＜45岁、嗜烟≥10年的脑梗死患者更易复发.服抗凝药可减少复发率,服药时间≥2年效果更好.对脑梗死患者应控制危险因素,服抗凝药预防复发.

Factors in associationwith recurrence of cerebral infarction

AIM: To identify the related factors and secondary prevention measures of the recurrence of cerebral infarction.METHODS: A retrospective study was conducted of 261 cases of cerebral infarction with complete clinical record using conditional logistic regression model and chi-square test.RESULTS: Such factors as the patient' s age of initial onset, sex, history of transient isc hemic attacks(TIA), hypertension, diabetes mellitus, hypercholesterolemia, use of anticoagulants and cigarette smoking were found to be associated with the recurrence of cerebral infa?tion( P ＜ 0. 05). For patients under 45-year of age, the recurrence rate of cerebral infarction was significantly higher than that for patients over 45 years old( P ＜ 0. 005), and a history over 10 years with cigarette smoking contributed to a higher recurrence rate than a history less than 10 years( P ＜ 0. 001) . Patients using anticoagulants(76 cases) were significantly different from those who took no anticoagulant(45 cases) in the recurrence rate( P ＜ 0.01), and anticoagulant use for no less than 2 years also made significant differences from the use less than 2 years( P ＜ 0. 01 ).CONCLUSION: The patient' s age of initial onset, history of TIA, hypertension, diabetes mellitus, hypercholesterolemia, anticoagulant use and cigarette smoking are all risk factors for recurrence of cerebral infarction. Patients younger than 45 years old with cigarette smoking for no less than 10 years are at greater risk for the recurrence. Taking anticoagulants may reduce the recurrence rate of cerebral infarction, and longer term use of them than 2 years may produce better effect. Patients with cerebral infarction need to control the risk factors and take anticoagulants for the prevention of the recurrence.