男性复发脑梗死相关危险因素的Logistic回归分析

摘要

目的 探讨与男性脑梗死复发相关的危险因素,并对按TOAST标准分型的各亚型复发性脑梗死患者的相关危险因素进行研究.方法 纳入2009年1月至2010年12月间于广元市中心医院神经内科首次发作和复发性脑梗死男性患者共264例.通过搜集患者病史、进行体格检查、记录辅助检查结果 等方法,对各项研究内容分别予以赋值.同时按照TOAST标准将复发性脑梗死患者按病因分型,分析TOAST各亚型出现脑梗死复发的相关因素.结果 其中初发性129例,复发性135例.年龄在38~85岁,平均年龄62.15±12.26岁.两组间高血压、房颤、高脂血症、不稳定斑块、吸烟、年龄、低密度脂蛋白和同型半胱氨酸具有统计学差异(P<0.05).Multiple Logistic回归分析结果 显示:年龄(OR=1.010,95CI%1.001-1.126,P＝0.029)、高血压(OR=2.705,95CI%1.807-3.876,P＝0.038)、房颤(OR=2.357,95CI%1.357-3.254,P＝0.027)和高脂血症(OR=2.154,95CI%1.255-4.026,P＝0.025)是脑梗死复发的危险因素.其中,按TOAST标准分型后,不明原因的缺血性脑卒中型(SUE)最多见,且在高血压和高脂血症人群中所占比例最高.总胆固醇(TC)和低密度脂蛋白(LDL)水平在复发性脑梗死大动脉粥样硬化性卒中型最高.结论 年龄、高血压、房颤和高脂血症是脑梗死复发的独立危险因素.高血压、高脂血症在脑梗死复发中起到更为重要的作用.%Objective To discuss and stud)' the relative risk factors of recurrent cerebral infarction and its subsets according to TOAST standards in male patients. Methods 264 male cases both new - onset and recurrent between January 2009 to December 2010 in Guangyuan Central Hospital were included. According to collecting the medical history, physical examination, assistant examination, we assigned values to the research contents respectively. At the same time, we analyzed the subsets of recurrent cerebral infarction according to TOAST standards. Results In this study, 129cases were new-onset and 135 cases were recurrent. The mean age of patients aged from 38 to 85 years is 62. 15 +_12. 26 years. Between the two groups, hypertension, atrial fibrillation, hyperlipidemia, unstable plaques, smoking, age, low density lipoprotein and homocysteine are statistically significant ( P < 0. 05 ). Logistic regression shows that age ( OR = 1. 010,95CI%( 1. 001-1. 126 ),P =0. 029 ), hypertension ( OR =2. 705,95CI% ( 1.807-3. 876 ),P =0.038), atrial fibrillation ( OR = 2. 357 ,95CI% ( 1. 357-3. 254 ),P = 0. 027 ), hyperlipidemia ( OR =2. 154,95CI%( 1. 255-. 026 ),P =0. 025 )are the independent risk factors of recurrent cerebral infarction. According to TOAST standards, unexplained ischaemic stroke type ( SUE ) is most frequent . It accounts for the highest proportion in the cases of hypertension and hyperlipidemia. Total cholesterol ( TC ) and low density lipoprotein ( LDL ) levels are the highest in aortic atherosclerotic stroke of recurrent cerebral infarction. Conclusion Age, hypertension, atrial fibrillation and hyperlipidemia are the independent risk factors of recurrent cerebral infarction. Hypertension and hyperlipidemia may play a more important role in the group of recurrent cerebral infarction, group of recurrence plays a more and more important role.