中国循证医学杂志

中国循证医学杂志

多发性脑梗死与单发性脑梗死危险因素对比分析

查看全文

目的 比较多发性脑梗死(MCI)与单发性脑梗死(SCI)的危险因素,以利于对其进行针对性的防治。
方法 前瞻性连续登记神经内科缺血性脑卒中患者,根据临床和影像学资料分为MCI和SCI组,对可能影响多发性脑梗死发病的24项因素先进行单因素分析,比较可能的危险因素在MCI与SCI组间有无差异,然后进行非条件logistic多元回归分析,校正混杂因素的影响。
结果 年龄、性别、高血压、糖尿病、心瓣膜病、吸烟、脑梗死史、入院首次收缩压等危险因素在MCI与SCI组间有显著差异,logistic多元回归分析显示,年龄[OR=1.014,95% CI 9(1.003,1.026)]、高血压[OR=1.566,95% CI (1.185,2.068)]、吸烟[OR=1.473,95% CI (1.052,2.061)]、脑梗死史[OR=1.948,95% CI (1.326,2.864)]为MCI的独立危险因素。
结论 与SCI相比,年龄、高血压、吸烟、脑梗死史为MCI的独立危险因素。

Objective To compare the risk factors between multiple cerebral infarction (MCI) and single cerebral infarction (SCI). This would be beneficial for carrying out corresponding prevention and treatment.
Methods We prospectively registered consecutive cases of ischemic stroke in the neurological wards and divided them into two groups: MCI group and SCI group according to their clinical and imaging data. Firstly, the single variable analyses of 24 factors that could be related to the onset of MCI were conducted, and then the multivariate non-condition stepwise logistic regression was performed.
Results Significant differences were noted between MCI group and SCI group in terms of age, gender, hpertension, diabetes, heart valvular disease, smoking, cerebral infarction history and first systolic blood pressure after admission. The logistic regression analyses showed that factors of age (OR=1.014, 95%CI 1.003 to 1.026), hypertension (OR=1.566, 95%CI 1.185 to 2.068), smoking (OR=1.473, 95%CI 1.052 to 2.061), cerebral infarction history (OR=1.948, 95%CI 1.326 to 2.864) were independent risk factors for MCI.
Conclusion Compared to SCI, age, hypertension, smoking and cerebral infarction history were independent risk factors for MCI patients.

关键词: 多发性脑梗死; 单发性脑梗死; 危险因素

Key words: Multiple cerebral infarction; Single cerebral infarction; Risk factors

引用本文: 赵松耀,刘鸣,刘志勤. 多发性脑梗死与单发性脑梗死危险因素对比分析. 中国循证医学杂志, 2008, 08(2): 75-78. doi: 10.7507/1672-2531.20080019 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
1. Roh JK, Kang DW, Lee SH, et al. Significance of acute multiple brain infarction on diffusion-weighted imaging. Stroke, 2000, 31(3): 688-694.
2. Bernasconi A, Bogousslavsky J, Bassetti C, et al. Multiple acute infarcts in the posterior circulation. J Neurol Neurosurg Psychiatry. 1996, 60(3): 289-296.
3. Bogousslavsky J, Bernasconi A, Kumral E. Acute multiple infarction involving the anterior circulation. Arch Neurol, 1996, 53(1): 50-57.
4. Meng J, Meng C, Yang P, et al. Cognitive impairment in multiple cerebral infarction. Chinese Medical Journal, 1995, 108(4): 315.
5. [No authors listed]. Stroke--1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke, 1989, 20(10): 1407-1431.
6. 周农, 高宗良. 多发性脑梗塞和单发性脑梗塞的对比分析. 安徽医科大学学报, 1990, 25(4): 275-277.
7. 郭宗君, 袁桂芬, 刘学生, 等. 不同病程单发及多发脑梗塞对病人认知障碍的影响. 中国实用内科杂志, 2000, 20(9): 561-562.
8. 汪凯, 卞兴华, 孟玉, 等. 多发梗塞性痴呆与多发性脑梗塞脑容积线性指标的对照研究. 安徽医科大学学报, 2002, 37(6): 451-453.
9. Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke, 2005, 36(4): 891-901.
10. Arauz A, Murillo L, Cantú C, et al. Prospective study of single and multiple lacunar infarcts using magnetic resonance imaging: risk factors, recurrence, and outcome in 175 consecutive cases. Stroke, 2003, 34(10): 2453-2458.
11. 李轶男. 高血压病患者并发缺血性脑卒中危险因素分析. 国外医学神经病学神经外科学分册, 1999, 2: 64.
12. Vermeer SE, Den Heijer T, Koudstaal PJ, et al. Incidence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke, 2003, 34(2):392-396.
13. Eguchi K, Kabino K, Hoshide S, et al. Smoking is associated with silent cerebrovascular disease in a high-risk Japanese community-dwelling population. Hypertens Res, 2004, 27(10): 747-754.
14. Yamagishi K, Iso H, Kitamura A, et al. Smoking raises the risk of total and ischemic strokes in hypertensive men. Hypertens Res, 2003, 26(3): 209–217.
15. Halperin RO, Michael Gaziano J, Sesso HD, et al. Smoking and the Risk of Incident Hypertension in Middle-aged and Older Men. American Journal of Hypertension, 2008, Epub ahead of print.