缺血性卒中风后血管事件的预测因素：中国缺血性卒中风登记研究。

Predictors of vascular events after ischemic stroke: the China ischemic stroke registry study.

机构信息

Institute of Neurology, WHO Collaborating Center for Research and Training in Neuroscience, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Neuroepidemiology. 2010;34(2):110-6. doi: 10.1159/000268823. Epub 2009 Dec 24.

DOI:10.1159/000268823

PMID:20051694

Abstract

BACKGROUND/AIMS: To measure the risk of vascular event occurrence among postischemic stroke patients in mainland China.

METHODS

In this multicenter prospective stroke registry study, we enrolled 1,951 patients diagnosed with acute ischemic stroke. Demographic data, prestroke risk factors, severity of neurological deficits and disability graded on the National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Scale scores of each patient were measured and recorded. Patients were followed up regularly for 12 months after recruitment. Clinical endpoints were defined as occurrence of vascular events or death.

RESULTS

We detected 103 cases with nonfatal vascular events and 27 cases that died of vascular events. Cumulative incidences of total vascular events, cerebrovascular events, and coronary artery diseases were 7.2, 5.0, and 1.8%, respectively, at 12 months after the initial ischemic stroke. Concomitant atherosclerotic-thrombotic diseases (HR, 1.68; 95% CI, 1.14-2.43) and baseline NIHSS (HR, 1.07; 95% CI, 1.03-1.11) were found to be the best predictors for further occurrence of a vascular event. Antiplatelet therapy (HR, 0.52; 95% CI, 0.35-0.77) is associated with a lower risk of further vascular events.

CONCLUSION

Our study provided valuable data on prognosis of acute ischemic stroke in Chinese patients.

摘要

背景/目的：评估中国大陆缺血性脑卒中后患者血管事件发生的风险。

方法

在这项多中心前瞻性脑卒中注册研究中，我们纳入了 1951 名急性缺血性脑卒中患者。记录了每位患者的人口统计学数据、卒中前的危险因素、神经功能缺损和美国国立卫生研究院卒中量表（NIHSS）残疾程度评分以及改良 Rankin 量表评分。患者在招募后定期随访 12 个月。临床终点定义为血管事件的发生或死亡。

结果

我们检测到 103 例非致命性血管事件和 27 例血管事件死亡。在初始缺血性卒中后 12 个月，总血管事件、脑血管事件和冠状动脉疾病的累积发生率分别为 7.2%、5.0%和 1.8%。同时存在动脉粥样硬化血栓性疾病（HR，1.68；95%CI，1.14-2.43）和基线 NIHSS（HR，1.07；95%CI，1.03-1.11）被发现是进一步发生血管事件的最佳预测因素。抗血小板治疗（HR，0.52；95%CI，0.35-0.77）与较低的进一步血管事件风险相关。