【摘要】：目的探討缺血性腦卒中復(fù)發(fā)的相關(guān)危險因素,為防治提供理論依據(jù)。 方法總結(jié)分析2011年9月-2012年9月就診于寧醫(yī)大總院心腦血管病醫(yī)院的寧夏地區(qū)401例缺血性腦卒中患者的臨床資料（本課題納入424例寧夏地區(qū)確診為初發(fā)缺血性腦卒中的患者，研究納入的患者均經(jīng)住院治療好轉(zhuǎn)后出院，出院時根據(jù)患者疾病診斷及病情需要選擇院外藥物并要求規(guī)律用藥，，在無禁忌癥情況下給予阿司匹林抗血小板聚集等二級預(yù)防，隨訪1年，失訪23例，最終獲得401例患者的資料），根據(jù)1年復(fù)發(fā)情況分為復(fù)發(fā)組與未復(fù)發(fā)組，通過住院登記記錄、門診復(fù)查、1年定期復(fù)查及電話聯(lián)系等方式收集、提取復(fù)發(fā)患者和未復(fù)發(fā)患者與本課題相關(guān)的臨床資料，包括：性別、年齡、卒中家族史、高血壓、TIA史、糖尿病、吸煙、飲酒、冠心病、房顫、頸動脈斑塊形成、高同型半胱氨酸血癥、高脂血癥等信息，其中復(fù)發(fā)組79例，未復(fù)發(fā)組322例，對所獲得的臨床資料采用卡方檢驗和多因素Logistic回歸進行統(tǒng)計分析。 結(jié)果單因素采用卡方檢驗顯示性別（X2=4.246， P=0.039）、年齡（X2=11.660，P=0.001）、高血壓（X2=13.813，P0.05）、糖尿�。╔2=32.427，P0.05）、吸煙（X2=5.421，P=0.029）、冠心�。╔2=6.964，P=0.008）、卒中家族史（X2=5.529，P=0.022）、TIA史（X2=7.019，P=0.010）、房顫（X2=6.574，P=0.019）、高同型半胱氨酸血癥（X2=35.930，P0.05）、高脂血癥（X2=5.530，P=0.027）、頸動脈斑塊形成（X2=68.054，P0.05），結(jié)果有統(tǒng)計學(xué)差異，說明男性、年齡≥60歲、高血壓、糖尿病、吸煙、卒中家族史、TIA史、高同型半胱氨酸血癥、高脂血癥、頸動脈斑塊形成是復(fù)發(fā)的危險因素；多因素分析顯示糖尿病、高同型半胱氨酸血癥、頸動脈斑塊形成的OR值(95%CI)分別為3.728(1.588-8.753),2.858(1.280-6.383),15.346(4.355-54.079)，均P0.05，說明糖尿病、高同型半胱氨酸血癥、頸動脈斑塊形成是缺血性腦卒中復(fù)發(fā)的獨立危險因素。 結(jié)論1．通過本研究發(fā)現(xiàn)糖尿病、高同型半胱氨酸血癥、頸動脈斑塊形成是缺血性腦卒中患者復(fù)發(fā)的獨立危險因素。2．男性、年齡≥60歲、高血壓、吸煙、卒中家族史、冠心病、糖尿病、TIA史、房顫、高同型半胱氨酸血癥、高脂血癥、頸動脈斑塊形成是缺血性腦卒中患者復(fù)發(fā)的危險因素。3．缺血性腦卒中復(fù)發(fā)危險因素的有效干預(yù)對控制復(fù)發(fā)有重要意義。
[Abstract]:Objective to explore the risk factors of ischemic stroke recurrence and provide theoretical basis for prevention and treatment. Methods from September 2011 to September 2012, 401 patients with ischemic stroke in Ningxia who were admitted to Yu Ning General Hospital for Cardiovascular and Cerebrovascular Diseases were analyzed. All the patients included in the study were discharged from hospital after hospitalization treatment. According to the patients' disease diagnosis and the need of the patients, the patients were required to take drugs regularly, and aspirin was given to prevent platelet aggregation and other secondary prevention under the condition of no contraindication. All patients were followed up for one year, 23 cases were lost, and 401 cases were obtained. According to the recurrence of one year, the patients were divided into two groups: recurrence group and non-recurrence group. The data were collected by means of hospitalization record, outpatient reexamination, 1 year periodic reexamination and telephone contact, etc. The clinical data of recurrent and non-recurrent patients were extracted, including sex, age, family history of stroke, hypertension, TIA history, diabetes, smoking, alcohol consumption, coronary heart disease, atrial fibrillation, carotid plaque formation. The information of hyperhomocysteinemia and hyperlipidemia were analyzed by chi-square test and multivariate Logistic regression. Results the univariate chi-square test showed sex (X2P 4.246, P0.039), age (X2P 11.660), hypertension (X2P 13.813P 0.05), diabetes mellitus (X2n 32.427P 0.05), smoking (X2P 5.421 P 0.029). Coronary heart disease (X2P 6.964), family history of stroke (X2P 5.529), TIA), atrial fibrillation (X2P 6.574n P0.019), hyperhomocysteinemia (X235.930P0.05), coronary heart disease (X2n 6.964), stroke family history (X2n 5.529P 0.022), TIA), atrial fibrillation (X 2n 6.574n P 0.019), hyperhomocysteinemia (X235.930P 0.05). Hyperlipidemia (X2 + 5. 530), carotid plaque formation (X2 + 68.054), the results showed that male, age 鈮

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