發(fā)布時間：2018-03-24 00:40

  本文選題：缺血性卒中　切入點(diǎn)：誘發(fā)因素　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探究6種常見誘因與缺血性卒中發(fā)病的相關(guān)性,以期對預(yù)防缺血性卒中提供指導(dǎo)。方法:連續(xù)收集2016年5月至2016年10月山西醫(yī)科大學(xué)第一醫(yī)院神經(jīng)內(nèi)科的缺血性卒中住院患者病例資料,并在發(fā)病到入院4天內(nèi)進(jìn)行誘因問卷調(diào)查,運(yùn)用病例交叉研究比較發(fā)病前2小時危險(xiǎn)期與發(fā)病前一天同一時間段對照期內(nèi)6種潛在誘因包括暴飲暴食、生氣、消極情緒、重體力活動、因驚人事件突然改變體位、喝咖啡的暴露情況;進(jìn)一步明確不同性別、年齡、病因?qū)W分型誘因暴露的差異情況。結(jié)果:1.共納入369例患者,年齡24~93歲,平均61.75±13.57歲,其中男性220例(59.6%),女性149例(40.4%);有91例患者(24.7%)僅在發(fā)病前2小時至少暴露于其中一種誘因,其OR值為6.1(95%CI:3.74~9.94);危險(xiǎn)期暴露于因驚人事件突然改變體位的OR值為12(95%CI:2.4~59.3),重體力活動的OR值為10.7(95%CI:4.2~27.6),生氣的OR值為8(95%CI:2.3~27.5),消極情緒的OR值為4.9(95%CI:2.3~10.3),暴飲暴食的OR值為2.5(95%CI:0.82~7.61),尚未發(fā)現(xiàn)暴露于喝咖啡者。2.不同性別、年齡之間誘因的暴露情況無統(tǒng)計(jì)學(xué)差異。不同病因?qū)W亞型患者誘因暴露資料顯示,重體力活動是心源性栓塞誘因(OR7.0,95%CI:4.7~41.9),消極情緒是大動脈粥樣硬化(OR 3.7,95%CI:1.1~12.0)、小動脈閉塞(OR 4.3,95%CI:1.1~11.8)的誘因,但各病因?qū)W亞型之間各誘因相對危險(xiǎn)度差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論:1.因驚人事件突然改變體位、重體力活動、生氣、消極情緒時是缺血性卒中發(fā)病的誘因。在腦血管病防治工作中應(yīng)重視誘因的影響。2.尚未發(fā)現(xiàn)暴飲暴食、喝咖啡與缺血性卒中之間有明顯相關(guān)性。3.不同性別、年齡、病因?qū)W分型誘因與缺血性卒中之間的關(guān)聯(lián)程度無明顯差異。
[Abstract]:Objective: to explore the relationship between six common inducements and ischemic stroke. Methods: from May 2016 to October 2016, the data of hospitalized patients with ischemic stroke in Department of Neurology, the first Hospital of Shanxi Medical University, were collected. A questionnaire survey on inducement was conducted from onset to admission within 4 days. Six potential inducements, including overeating, anger, negative emotion, were compared between the risk period of 2 hours before onset and the control period in the same time period before onset of disease. Heavy physical activity, sudden change of posture due to amazing events, exposure to coffee drinking, and further determination of the differences in the causes of exposure to different sex, age, etiological typing. Results: a total of 369 patients were included, aged 241.93 years, with an average of 61.75 鹵13.57 years old. Among them, 220 men (59.6%) and 149 women (40.4%) were exposed to at least one of the inducements only two hours before the onset of the disease. Its OR value is 6.1- 95 CI: 3.749.94; the OR value of sudden change of position in dangerous period is 1295 CI: 2.4% 59.3%; OR value of heavy physical activity is 10.7% 95 CI: 4.2% 27.6; OR value of angry is 8.95 CI: 2.3kW 27.55.OR value of negative emotion is 4.995% CI2.310.3, OR value of overeating is 2.595 CI0.827.61g, it has not been found that exposure to drinking and drinking. Coffee maker by sex, There was no statistical difference between age and age in the exposure of inducements. According to the data of inducement exposure in patients with different etiological subtypes, heavy physical activity was the inducement of cardiogenic embolism, and negative emotions were OR 3.7 ~ 95 CI: 1.1C: 12.0, OR 4.39 95 CI: 1.1 / 11.8), negative emotion was the inducement of large artery atherosclerosis (OR 3.7 ~ 95 CI: 1.1C: 12.0, OR 4.39 95 CI: 1.1 + 11.8). However, there was no significant difference in the relative risk of various inducements among the subtypes of etiology. Conclusion: 1. Sudden changes in posture, heavy physical activity, and anger as a result of amazing events, Negative emotion is the inducement of ischemic stroke. In the prevention and treatment of cerebrovascular disease, we should pay attention to the influence of inducement. 2. It has not been found that overeating, drinking coffee and ischemic stroke have obvious correlation .3. different sex, age, There was no significant difference between etiological classification inducement and ischemic stroke.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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