脑卒中复发影响因素的Cox回归分析

目的 探讨脑卒中复发的主要影响因素.方法 2 065例脑卒中新发病例为研究人群,随访患者的复发情况,调查影响复发的各种因素.随访时间为3年.应用Cox比例风险回归模型对影响脑卒中复发的各种因素进行单因素和多因素分析.结果 截至随访终点,受访病例共1 881例,失访病例184例.复发病例327例（17.38%）,6个月内复发45例（13.76%）,6个月至1年复发68例（20.80%）,1～2年复发97例（29.66%）,～3年复发117例（35.78%）.单因素Cox回归分析：高龄（RR=1.48）、吸烟（RR=1.35）、脂肪摄入（RR=1.83）、高血压史（RR：2.54）、糖尿病史（RR=1.72）、高脂血症（RR=1.83）、脑卒中家族史（RR=2.62）、抑郁（RR=1.84）、生活事件（RR=2.53）、纤维蛋白原（RR=1.75）、颈动脉斑块（RR=2.68）为脑卒中复发的危险因素;女性（RR=0.64）、运动（RR=0.33）、社会支持（RR=0.36）为脑卒中复发的保护因素.多因素Cox回归分析表明：高血压史（RR=1.86）、高脂血症（RR=1.95）、脑卒中家族史（RR=2.62）、生活事件（RR=2.38）、颈动脉斑块（RR=2.77）是引起脑卒中复发的危险因素;运动（RR=0.35）、社会支持（RR=0.32）是脑卒中复发的保护因素.结论 对脑卒中患者的高血压史、高脂血症、脑卒中家族史的预防、多参加体育运动、增强对生活事件的应对能力,有助于脑卒中复发的预防.

Cox regression analysis on main influencing factors of recurrent stroke

Objective To explore the main influencing factors of recurrent stroke.Methods 2 065 new stroke patients were selected as study populations.The recurrent stroke status and kinds of influencing factors were followed up.The follow-up study time was 3 years.Single factor and multi-factor analysis methods were carried out for influencing factom of recurrent stroke by Cox proportional hazaIds regression models.Results By the end.1 881 pa%);45 patients were recurrent in 6accepted visit,184 were lost follow-up.327 patients were recurrent(17.38tients months(13.76%);68 patients were recurrent during 6 months to 1 year(20.80%);97 patients were recurrent during 1 year to 2 years(29.66%);117 patients were recurrent after 3 years(35.78%).Single factor Cox regression analysis:The risk factors of recurrent stroke were advanced age(RR=1.48),smoking(RR=1.35),fat intake(RR=1.83),hypertension history(RR=2.54),diabetes history(RR=1.72),high lipemia(RR=1.83),stroke family history(RR=2.62),depression(RR=1.84),life events(RR=2.53),fibrinogen(RR=1.75),carotid plaques(RR=2.68);The protecting favors of recurrent stroke were female(RR=0.64),sports(RR=0.33),social support(RR=0.36).Multi-factor Cox regression analysis:the risk factors of recurrent stroke were hypertension history(RR=1.86),high lipemia(RR=1.95),stroke family history(RR=2.62),life events(RR=2.38),carotid plaques(RR=2.77);The protecting factors of recurrent stroke were sports(RR:0.35),social support(RR=0.32).Conclusion The prevention of hypertension history,high lipemia,the family history of stroke,more supports and the high ability of answering life events could help to prevent the recurrent stroke.