家庭因素与缺血性脑卒中复发关系的随访研究

目的 探讨家庭因素与缺血性脑卒中复发的关系,为临床提供参考。 方法 选择2015年6月—2016年5月浙江中医药大学附属第二医院神经内科收治的121例急性缺血性脑卒中患者为研究对象,随访2年,依据是否复发分为预后差与预后好组。采集患者的家庭和临床资料,选用家庭亲密度与适应性量表对患者家庭进行评价,并对主要照顾者进行脑卒中知识评估。应用logistic回归分析分析家庭和临床因素对缺血性脑卒中复发的影响,并使用Pearson相关分析分析家庭因素与患者临床特征的关系。 结果 预后差组患者来自农村家庭、人口数多家庭和失衡型家庭比例多于预后好组,而患者所受教育、家庭人均月收入和主要照顾者脑卒中知识少于预后好组,差异均有统计学意义(均P<0.05)。Logistic回归分析显示:在家庭因素中,患者文化程度低、家庭人均收入低、主要照顾者脑卒中知识少及失衡型家庭是缺血性脑卒中预后差的独立危险因素。主要照顾者脑卒中知识水平与患者LDL-C水平呈负相关(r=-0.793,P=0.018)。 结论 在家庭因素中,患者文化水平低、家庭人均收入低、主要照顾者脑卒中知识少及失衡型家庭是缺血性脑卒中患者复发的独立危险因素。主要照顾者脑卒中知识越少,患者LDL-C水平越高。 

A follow-up study on the relationship between family factors and recurrence of ischemic stroke

Objective To explore the relationship between family factors and recurrence of ischemic stroke. Methods A total of 121 patients with acute ischemic stroke hospitalized in the Department of Neurology, the Second Affiliated Hospital of Zhejiang Chinese Medical University from June 2015 to May 2016 were followed up for 2 years. The patients were divided into poor prognosis group and good prognosis group according to recurrence. Family and clinical data of the patients were collected. Family intimacy and adaptability scale was used to evaluate patient's families, and stroke knowledge was assessed for the primary caregivers. The influence of family and clinical factors on the recurrence of ischemic stroke was analyzed by logistic regression. The relationship between family factors and clinical features of patients was analyzed by Pearson correlation analysis. Results The proportion of patients in poor prognosis group from rural areas? imbalanced families and families with large population was higher than that in good prognosis group, while the education, the average family income and the knowledge level of primary caregivers in poor prognosis group were lower than that in good prognosis group(all P<0.05). Logistic regression analysis showed that in family factors low education level of patients, low average family income, poor stroke knowledge of primary caregiver and imbalanced type of families were independent crisis factors for poor prognosis in ischemic stroke. The stroke knowledge level of primary caregivers was negatively correlated with the patient's LDL-C level(r=-0.793, P=0.018). Conclusion In family factors, low education level, low average family income, poor stroke knowledge of primary caregivers and imbalanced family type are independent risk factors for recurrence of ischemic stroke. The less the primary caregiver knows about stroke, the higher the patient has LDL-C level.