年龄与急性脑梗死患者1年预后的关系研究

目的 探讨不同年龄急性脑梗死患者1年预后的差异。 方法 回顾性分析任丘康济新图医院神经内科2014年1月-2018年11月连续收治的急性脑梗死患者 的临床资料，根据年龄分为青中年组（＜60岁）和老年组（≥60岁）。比较两组急性脑梗死患者的临 床资料，采用多因素logistic回归分析年龄与1年死亡、预后不良（mRS＞2分）及卒中复发的关系。 结果 最终纳入急性脑梗死患者3996例，年龄22～98岁，平均64.83±11.28岁，男性2481例 （62.09%）；青中年组1214例（30.38%），老年组2782例（69.62%）。老年组男性比例、文化水平、过 量饮酒、糖尿病、住院期间静脉溶栓治疗比例低于青中年组，舒张压、空腹血糖、TG、TC、LDL-C、白 细胞计数、压疮评分低于青中年组；老年组吸烟、心房颤动、冠心病、卒中史、颈动脉狭窄比例，住 院期间新发肺炎、新发消化道出血及质子泵抑制剂治疗比例，以及收缩压、HDL-C、Hcy、胱抑素-C、 纤维蛋白原、入院NIHSS评分、跌倒评分高于青中年组，以上差异均有统计学意义。多因素logistic回 归分析结果显示，老年组患者1年死亡风险（OR 2.770，95%CI 1.479～5.189，P =0.001）、预后不良 风险（OR 1.721，95%CI 1.301～2.275，P＜0.001）及卒中复发风险（OR 1.396，95%CI 1.011～1.927， P =0.043）均显著升高。 结论 急性脑梗死患者老年组1年死亡、预后不良及卒中复发风险均较高，临床应加强对老年急性 脑梗死患者卒中危险因素的筛查及干预，以降低患者的不良预后风险。

Correlation between Age and 1-Year Prognosis of Patients with Acute Cerebral Infarction

Objective To explore the correlation between age and 1-year prognosis of the patients with acute cerebral infarction (ACI). Methods The eligible ACI patients admitted to Department of Neurology, Renqiu Kangjixintu Hospital from January 2014 to November 2018 were enrolled in this retrospective analysis, and all the subjects were divided into the young and middle-aged group (<60 years old) and the elderly group (≥60 years old) according to the age. The clinical data of both groups were compared. Multivariate logistic regression analysis was used to determine the relationship between age and 1- year death, poor prognosis (mRS >2 points) and stroke recurrence. Results A total of 3996 ACI patients were included, with an average age of 64.83±11.28 years old (range: 22-98 years) and 2481 males (62.09%). 1214 cases (30.38%) were in the young and middleaged group, and 2782 cases (69.62%) in the elderly group. The proportion of male, educational level, excessive drinking, diabetes and intravenous thrombolysis during hospitalization, waslower in the elderly group than in the young and middle-aged group, as well as the diastolic blood