脑梗死患者复发的影响因素分析

摘要

Objective To explore the influencing factors of recurrence in patients with cerebral infarction for substanti-ating the evidence for the prevention of recurrence of cerebral infarction.Methods A total of 450 patients(244 cases with-out recccurence,206 cases with recurrence within 5 years of first attack)with cerebral infarction from the First Affiliated Hospital of Harbin Medical University during April and July 2011 were included in the study. We retrospectively investiga-ted the risk factors for recurrence.Results The recurrence rate of cerebral infarction in different ages patients,whether reg-ular applicate anti-platelet drugs and statins,different educational levels have significant difference. A logistic regression analysis showed that the risk factors for the recurrence of cerebral infarction were:age(OR=3.392,95% CI 1.226-9.381), level of education(OR=0.049,95% CI 0.015-0.160),compliance of oral antiplatelet drugs(OR=3.150,95% CI 1.434-6.916),and compliance of oral statins(OR=3.490,95% CI 1.305-9.336).Patients with older age,lower education level, and poorer compliance with anti-platelet and statin drugs were associated with an increased recurrence risk of cerebral infarction. Conclusion Low control ratio of risk factors and poor drug compliance are the risk factors for the recurrence of cerebral infarction.It is necessary to emphasize the education of secondary prevention in patients with cerebral infarction, build a mechanism for long-term follow-up and periodically guide secondary prevention for the patients.%目的 探讨脑梗死患者复发的影响因素,为脑梗死复发的预防工作提供依据.方法 选取2011年4—7月哈尔滨医科大学附属第一医院神经内科住院的450例首发脑梗死患者,其中首发后5年内未复发244例、复发206例,对影响复发的可能因素进行分析.结果 不同年龄,抗血小板药物服用方式,他汀类药物服用方式,以及受教育程度复发率比较差异有统计学意义(P<0.05).Logistic回归分析显示,影响脑梗死复发的危险因素有:年龄(OR=3.392,95% CI 1.226 ~9.381),受教育程度(OR =0.049,95% CI 0.015 ~0.160),抗血小板药物(OR =3.150,95% CI 1.434~6.916)和他汀类药物服药依从性(OR=3.490,95% CI 1.305~9.336),年龄越大,受教育程度越低,抗血小板和他汀类药物依从性越差则脑梗死复发风险越高.结论 脑梗死复发患者危险因素控制率低,用药依从性差.应该重视加强脑梗死患 者二级预防的宣传教育,建立随访机制,定期对患者进行二级预防指导.