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医学免费论文:缺血性卒中功能预后及其影响因素的回顾性研究
【摘要】 目的 对缺血性卒中患者进行随访，观察功能预后情况并对其影响因素进行分析。方法 回顾性收集2002年1月～2005年6月第四军医大学西京医院神经内科确诊的连续性缺血性卒中病例作为研究对象，采用电话、信访等方式随访，改良Rankin评分为结局指标，2006年1月完成随访工作。对影响功能预后的因素进行单因素和多元logistic回归分析。结果 846例缺血性卒中病例中，不符合纳入标准169例，排除60例，资料不全者128例。随访时间最长47个月，失访55例(11.2%)，最终纳入分析434例，其中预后良好者244例(56.2%)，预后不良者190例(43.8%)。单因素及多元logistic回归分析显示，年龄(OR=3.51;95% CI:2.10～5.85)、教育程度(OR=0.69;95% CI:0.57～0.83)、脑卒中史(OR=2.48;95% CI:1.44～4.27)、NIHSS评分(OR=2.62;95% CI:1.58～4.33)和缺血性脑卒中预后不良明显相关。结论 高龄、教育程度低、有脑卒中史、NIHSS评分高是不良预后的主要影响因素。
【关键词】 脑血管意外; 回顾性研究; 预后医.学.全.在.线www.lindalemus.com
Retrospective study of functional prognosis and influential factors of ischemic stroke
LIU Xuedong, WANG Bo, LIU Ya, ZHAO Gang, WU Zhongliang, LIU Zhirong, Lü Yali, XU Dezhong
1.Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China; 2.Department of Epidemiology, Fourth Military Medical University, Xi'an 710032, China; 3.Outpatient Department, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China; 4.The Central Hospital of Xi'an Railway Bureau, Xi'an 710054, China
【Abstract】 Objective To observe the functional prognosis and to analyze the influential factors of ischemic stroke patients. Methods Continuous ischemic stroke cases were retrospectively collected in the Neurology Department in Xijing Hospital of the Fourth Military Medical University from January 2002 to June 2005. Followup was done through phone or mail and mRS score made as the primary outcome. The followup was finished in January 2006. The influential factors were analyzed by monovariant and multivariant logistic regression. Results 846 continuous cases were collected, 169 of which did not meet the inclusion criteria; 60 cases were excluded; 128 cases had missing data. The followup time was up to 47 months, and 55 cases (11.2%) were lost. Thus, the remaining 434 patients were analysized. Monovariant and multivariant logistic regression analyses showed that the poor outcome was associated with age (OR=3.51; 95% CI:2.10～5.85), educational level (OR=0.69; 95% CI:0.57～0.83), stroke history (OR=2.48; 95% CI:1.44～4.27), and NIHSS total scores (OR=2.62; 95% CI:1.58～4.33). Conclusions The results suggest that older age, lower educational level, having stroke history, and higher NIHSS total scores were influential factors of functional outcome of ischemic stroke.
【Key words】 Cerebrovascular accident; Restrospective studies; Prognosis (Chin J Dis Control Prev 2008，12(1)：1720)
脑卒中在我国疾病死亡原因中已排第2位，其中缺血性卒中占60%～80%。随着人口老龄化的加剧，脑卒中已成为威胁老年人健康的重要危险因素。卒中预后是临床医生和患者均非常关心的问题，目前，国外在此方面进行了大量研究，证实许多因素与预后有关，如性别、年龄、卒中严重程度及一些实验室指标，但目前国内有关脑卒中的预后研究较少，且样本量较小，许多研究并未区分出血性脑卒中和缺血性脑卒中。本研究采用以医院为基础的回顾性研究，确定预测缺血性脑卒中功能预后的因素。
