Objective: To explore the risk factors for recurrence of large atherosclerotic cerebral infarction in first?episode patients.
Methods: The consecutive patients with acute cerebral infarction diagnosed in the Department of Neurology were screened for large atherosclerotic cerebral infarction by CTA/MRA examination, and all the confirmed patients were followed up for 1 year. The patients were divided into recurrent ischemic stroke group and non?recurrent group according to occurrence of cerebrovascular events during the follow?up.
Results: A total of 256 eligible patients were included in this study, and all of them completed the follow?up. During the 1?year follow?up, 30 (11.7%) patients had ischemic cerebrovascular stroke events. Univariate analysis showed significant differences in alcohol drinking (P=0.028), smoking (P=0.007), high?density lipoprotein cholesterol (HDL; P=0.045), ischemic heart disease (P=0.002), antihypertensive agents (P=0.036) and statin use (P=0.016) between the recurrent group and non?recurrent group. Cox regression analysis showed that irregular use of statins (RR=0.410, P=0.043), smoking (RR=2.253, P=0.043), HDL (RR=0.327, P=0.029), and ischemic heart disease (RR=8.566, P<0.001) were correlated with recurrent ischemic stroke.
Conclusion: The first?episode patients with irregular use of statins, low HDL levels, smoking and ischemic heart disease are at higher risks for having ischemic stroke recurrence.
目的: 研究首发大动脉粥样硬化性脑梗死患者复发的危险因素。
方法: 连续入组在神经内科就诊的首发缺血性卒中患者，并经CTA或MRA证实为大动脉粥样硬化性脑梗死。所有入组患者进行1年随访，根据随访期间是否复发脑梗死分为缺血性卒中复发组和非复发组，比较两组患者的临床资料，并通过单因素方差分析、Cox回归模型确定复发性缺血性卒中的独立预测因素。
结果: 256例符合纳入标准，全部病例完成随访，30例（11.7%）随访期间发生缺血性脑血管事件。单因素方差分析显示，复发组与非复发组在饮酒习惯（P = 0.028）、吸烟（P = 0.007）、高密度脂蛋白胆固醇（P = 0.045）、缺血性心脏病（P = 0.002）、抗高血压药物（P = 0.036）和他汀类药物（P = 0.016）使用方面的差异有统计学意义。Cox回归分析显示不规则使用他汀类药物（HR=0.410，P = 0.043）、吸烟（HR=2.253，P = 0.043）、高密度脂蛋白胆固醇（HR=0.327，P = 0.029）、缺血性心脏病（HR=8.566，P < 0.001）与缺血性脑卒中复发相关。
结论: 不规则使用他汀类药物、低高密度脂蛋白水平、吸烟和既往有冠心病患者缺血性卒中复发风险较高。