本文選題：進展性缺血性腦卒中　切入點：危險因素　出處：《重慶醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：運用系統(tǒng)評價Meta分析方法綜合評價高血壓病史、腦卒中病史、高脂血癥、糖尿病病史、冠心病病史、煙酒史、入院時纖維蛋白原增高、頸動脈狹窄、入院時高血壓、高血糖、發(fā)熱與我國人群進展性缺血性腦卒中關系的文獻行系統(tǒng)評價，綜合分析以上危險因素與我國人群進展性缺血性腦卒中的相關性，為制定腦卒中的預防決策提供循證依據。 方法：通過計算機檢索國內多個數據庫，收集以上危險因素糖與我國人群進展性缺血性腦卒中的相關的流行病學文獻，按Cochrane系統(tǒng)評價方法評估納入文獻的質量，并運用RevMan5.0軟件對國內有關進展性缺血性腦卒中發(fā)病危險因素的研究結果進行定量綜合分析；進行異質性檢驗以及合并OR值和95%可信區(qū)間的計算。 結果：有5篇文獻納入本次研究，共有1489例患者，其中進展性缺血性腦卒中組480例，非進展組1009例。我國人群進展性缺血性腦卒中發(fā)生的各危險因素合并比值比(OR值)及95%可信區(qū)間(95%CI)分別為糖尿病病史2.31[1.70，3.28]、腦卒中病史1.84[1.37，2.46]、頸動脈狹窄1.39[1.07，1.79]、入院時高血糖3.18[1.84，5.48]、入院時發(fā)熱3.33[1.77，6.28]，P值均0.05，有統(tǒng)計學意義；高血壓病史、冠心病病史、煙酒史、入院時纖維蛋白原升高、入院時高血壓合并OR值雖然均大于1,但是它們的95%CI均包含“1”，高脂血癥合并OR值0.92，以上P值均0.05，無統(tǒng)計學意義。根據本研究所收集的資料特點，對各個不同危險因素分別進行敏感性及累積性分析，腦卒中病史、糖尿病病史、高血壓病史、高脂血癥、冠心病史及入院時發(fā)熱及高血糖結果可靠，，可信度高；煙酒史、入院時纖維蛋白原增高及高血壓、頸動脈狹窄結果穩(wěn)定性差，可信度不高。 結論：1、影響中國進展性缺血性腦卒中發(fā)病的主要危險因素為入院時發(fā)熱、入院時高血糖、糖尿病病史、腦卒中病史、頸動脈狹窄； 2、以OR為效應指標，按照Wynder標準，糖尿病病史、入院時發(fā)熱及高血糖與進展性缺血性腦卒中的發(fā)生呈中度關聯，腦卒中病史及頸動脈狹窄與之呈弱關聯。
[Abstract]:Objective: to evaluate the history of hypertension, stroke, hyperlipidemia, diabetes, coronary heart disease, alcohol and tobacco, increase of fibrinogen on admission, stenosis of carotid artery and hypertension on admission by Meta analysis. A systematic review of the relationship between hyperglycemia, fever and progressive ischemic stroke in Chinese population was carried out to analyze the correlation between the above risk factors and progressive ischemic stroke in Chinese population. To provide evidence-based basis for stroke prevention decision-making. Methods: a number of databases were searched by computer to collect the epidemiological literature on the relationship between the above risk factors sugar and progressive ischemic stroke in Chinese population. The quality of the literatures was evaluated according to the Cochrane system evaluation method. RevMan5.0 software was used to analyze the risk factors of progressive ischemic stroke in China quantitatively and synthetically. The heterogeneity test and the calculation of OR value and 95% confidence interval were also carried out. Results: a total of 1489 patients were included in this study, including 480 patients with progressive ischemic stroke. There were 1 009 cases in the non-progressive group. The ratio of risk factors associated with progressive ischemic stroke in Chinese population was higher than OR) and 95% CI (95 CI) was diabetes history 2.31 [1.703.28], stroke history 1.84 [1.3772.46], carotid stenosis 1.39 [1.071.79], and hyperglycemia on admission. 3.18 [1.84 鹵5.48] and 3.33 [1.77 鹵6.28] P values at admission, which were statistically significant. History of hypertension, history of coronary heart disease, history of tobacco and alcohol, increase of fibrinogen on admission, At admission, the OR values of hypertension complicated with hypertension were all greater than 1, but their 95 CI included "1", hyperlipidemia with OR value of 0.92and the above P values were 0.05. there was no statistical significance according to the characteristics of the data collected in this study. The history of stroke, diabetes, hypertension, hyperlipidemia, coronary heart disease, fever and hyperglycemia on admission were analyzed with high reliability and reliability. High fibrinogen and hypertension at admission, carotid artery stenosis results in poor stability, credibility is not high. Conclusion the main risk factors affecting progressive ischemic stroke in China are fever on admission, hyperglycemia on admission, history of diabetes, history of stroke and stenosis of carotid artery. 2. According to Wynder criteria, diabetes history, fever and hyperglycemia were moderately correlated with progressive ischemic stroke, and stroke history and carotid stenosis were weakly correlated with OR.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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