Wang Zhan, Shi Yuzhi, Wang Anxin, Wang Chunxue, Wang Yongjun
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Sep;53(9):706-9.
To explore the risk factors and their prognostic value in Chinese female patients with ischemic stroke.
A total of 4 442 female patients with ischemic stroke were enrolled in the study from the Chinese National Stroke Registry System. According to the modified Rankin Scale (mRS) score, patients were divided into the group A (with good outcomes, mRS = 0-2) and the group B(with bad outcomes, mRS = 3-6), with the follow-up for 12 months. The risk factors were collected at month 3 and month 12, including age, family history, body mass index (BMI), hypertension, diabetes mellitus (DM), hyperlipidemia, atrial fibrillation (AF), coronary heart disease (CHD), smoking and moderate or heavy alcohol intake. The multivariate logistic regression was performed to determine the prognostic value of those risk factors.
Patients in the group B were older than those in the group A [month 3: (71.3 ± 11.4) years old vs (65.5 ± 11.8) years old and month 12: (71.9 ± 11.3) years old vs (65.1 ± 11.6) years old, with both P < 0.001]. Patients in the group B were found to have higher ratio of BMI < 25 kg/m(2) (66.3% vs 62.0%, P = 0.006; 66.6% vs 61.8%, P = 0.002) and more likely to have the history of DM (27.0% vs 23.3%, 26.6% vs 23.6%, respectively; both P < 0.05), AF (18.0% vs 6.2%, 17.9% vs 6.3%, respectively; both P < 0.001) and CHD (21.4% vs 14.4%, 21.8% vs 14.2%, respectively; both P < 0.001) than those in the group A. The multivariate logistic regression analysis showed that women's age (OR = 1.04, 1.05, 95%CI 1.03-1.05, 1.04-1.06, respectively), the histories of DM (both OR = 1.35, 95%CI 1.15-1.58, respectively) and AF(OR = 2.91, 2.84, 95%CI 2.33-3.64, 2.27-3.56, respectively) were significantly associated with the bad outcomes at month 3 and month 12. The history of CHD was associated with the bad outcomes at month 12 (OR = 1.20, 95%CI 1.00-1.43), while the history of hyperlipidemia might improve the outcome at month 12 (OR = 0.75, 95%CI 0.60- 0.94).
The risk factors may have different prognostic value in female patients with ischemic stroke. The diagnosis and treatment for DM, AF and CHD may be helpful to improve the prognosis in Chinese female patients with ischemic stroke.
探讨中国女性缺血性脑卒中患者的危险因素及其预后价值。
从中国国家脑卒中登记系统纳入4442例女性缺血性脑卒中患者。根据改良Rankin量表(mRS)评分,将患者分为A组(预后良好,mRS = 0 - 2)和B组(预后不良,mRS = 3 - 6),随访12个月。在第3个月和第12个月收集危险因素,包括年龄、家族史、体重指数(BMI)、高血压、糖尿病(DM)、高脂血症、心房颤动(AF)、冠心病(CHD)、吸烟及中度或重度饮酒。采用多因素logistic回归分析确定这些危险因素的预后价值。
B组患者年龄大于A组[第3个月:(71.3±11.4)岁对(65.5±11.8)岁;第12个月:(71.9±11.3)岁对(65.1±11.6)岁,P均<0.001]。发现B组患者BMI<25 kg/m²的比例更高(分别为66.3%对62.0%,P = 0.006;66.6%对61.8%,P = 0.002),且更易有DM病史(分别为27.0%对23.3%,26.6%对23.6%;P均<0.05)、AF病史(分别为18.0%对6.2%,17.9%对6.3%;P均<0.001)和CHD病史(分别为21.4%对14.4%,21.8%对14.2%;P均<0.001)。多因素logistic回归分析显示,女性年龄(OR分别为1.04、1.05,95%CI分别为1.03 - 1.05、1.04 - 1.06)、DM病史(OR均为1.35,95%CI均为1.15 - 1.58)和AF病史(OR分别为2.91、2.84,95%CI分别为2.33 - 3.64、2.27 - 3.56)与第3个月和第12个月的不良预后显著相关。CHD病史与第12个月的不良预后相关(OR =