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目的:探讨脑梗死复发的相关因素及二级预防方法。方法:回顾性分析了资料完整的261例脑梗死患者,采用Logistic回归模型方法及χ2检验方法。结果:首次发病年龄、性别、既往短暂性脑缺血发作史、原发性高血压史、糖尿病史、高脂血症、服抗凝药及嗜烟与脑梗死复发相关(P值均小于0.05)。年龄<45岁的脑梗死患者复发高于≥45岁的脑梗死患者(P<0.005)。嗜烟≥10年的脑梗死患者复发高于嗜烟<10年的脑梗死患者(P<0.001)。服抗凝药组(76例)与未服抗凝药组(45例)复发率比较差异有显著性意义(P<0.01)。服抗凝药≥2年的患者与服抗凝药<2年的患者复发率比较差异有显著性意义(P<0.01)。结论:首次发病年龄、短暂性脑缺血发作史、原发性高血压史、糖尿病史、高脂血症及嗜烟是脑梗死复发的危险因素,年龄<45岁、嗜烟≥10年的脑梗死患者更易复发。服抗凝药可减少复发率,服药时间≥2年效果更好。对脑梗死患者应控制危险因素,服抗凝药预防复发。
Objective: To explore the relapse factors of cerebral infarction and secondary prevention methods. Methods: A total of 261 patients with cerebral infarction were retrospectively analyzed. Logistic regression model and χ2 test were used. Results: The first onset age, gender, previous history of transient ischemic attack, history of essential hypertension, history of diabetes, hyperlipidemia, anticoagulants and smoking were related to the recurrence of cerebral infarction (P <0.05 ). Patients with cerebral infarction <45 years of age had a higher relapse rate than those with> 45 years of age (P <0.005). Recurrence was higher in patients with cerebral infarction who were more than 10 years old and those who were more than 10 years old (P <0.001). There was significant difference in the recurrence rate between the anticoagulant group (76 cases) and the non-anticoagulant group (45 cases) (P <0.01). Patients with anticoagulants ≥ 2 years and patients with anticoagulants <2 years had significantly different recurrence rates (P <0.01). Conclusion: The first onset age, history of transient ischemic attack, history of essential hypertension, history of diabetes mellitus, hyperlipidemia and smoking are the risk factors of recurrent cerebral infarction. Aged 45 years old, Patients with cerebral infarction more likely to relapse. Taking anticoagulants can reduce the recurrence rate, medication time is better than 2 years. Patients with cerebral infarction should control the risk factors, anticoagulants to prevent recurrence.