老年人脑梗死复发的相关危险因素分析

摘要

Objective To explore the risk factors for the recurrence of senior patients with cerebral infarction ,and provide refer-ences for its prevention .Methods The 102 elder patients(age>65y) with cerebral infarction were regarded as recurrent group ,and 218 elder cerebral infarction patients without recurrence were considered as primary group .The sex ,age ,body mass index(BMI) , heavy smoking ,drunkenness ,TIA ,location of primary cerebral infarction ,using anti-platelet drugs ,diabetes ,hypertension ,coronary heart disease ,hyperlipidemia ,carotid atherosclerotic plaque ,fibrillation atrial ,chronic obstructive pulmonary diseases (COPD) ,in-creased serum levels of homocysteine(Hcy) ,and high level of C reaction protein(CRP) were analyzed by single and multi factors a-nalysis .Results The single analysis showed the factors including hypertension ,TIA ,carotid atherosclerotic plaque ,heavy smoking , hyperlipidemia ,diabetes ,coronary heart disease ,increased serum levels of homocysteine (Hcy) ,and high level of C reaction protein (CRP) were risk factors for the recurrence of senior patients with cerebral infarction ,but using anti-platelet drugs was the protec-tive factor .Multi-factors analysis showed the factors including coronary heart disease ,hyperlipidemia ,TIA ,diabetes ,carotid athero-sclerotic plaque ,hypertension ,heavy smoking were isolated risk factors but using anti-platelet drugs was the protective factor .Con-clusion There are multitude factors for the recurrence of senior patients with cerebral infarction .We must pain more attention to the factors and decrease their recurrence .%目的探讨影响老年脑梗死患者复发的危险因素，为其二级预防提供参考。方法选择年龄在65岁以上的老年脑梗死复发患者102例为复发组，同期初发病例218例为对照组。对两组患者性别、年龄、体质量指数（BMI）、嗜烟、嗜酒、短暂性脑缺血发作（T IA ）、首发脑梗死部位、平时预防性使用抗血小板药物、伴糖尿病、高血压、冠心病、高脂血症、颈动脉粥样硬化性斑块、房颤、慢性阻塞性肺疾病（COPD）、血清半胱氨酸（Hcy）水平增高、血清超敏C反应蛋白（CRP）增高等多种危险因素进行单因素和多因素回归分析。结果单因素分析发现高血压、TIA、伴颈动脉斑块、嗜烟、高脂血症、糖尿病、冠心病、Hcy升高、CRP升高这9项因素是老年脑梗死患者复发的危险因素、接受抗血小板治疗为保护因素。多因素分析发现冠心病、高脂血症、T IA、糖尿病、颈动脉斑块、高血压、嗜烟是老年脑梗死复发的独立危险因素，而接受抗血小板治疗是保护因素。结论影响老年脑梗死患者复发的危险因素众多，临床上应高度重视，减少老年脑梗死患者的复发。