Department of Neurology, Guangdong Second Provincial General Hospital, 466 Middle Xingang Road, Guangzhou, 510317, Guangdong, China.
Center for Cerebrovascular Diseases, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China.
J Neurol. 2019 May;266(5):1194-1202. doi: 10.1007/s00415-019-09249-5. Epub 2019 Feb 19.
The previous studies have shown that recurrent stroke (RS) adversely affects the life of survivors of ischemic stroke (IS). However, lifestyle associated with RS has received a little systematic study in Chinese Han patients. We aimed to perform a comprehensive assessment of lifestyle and the potential risk factors associated with RS in Chinese Han inpatients with first-ever acute ischemic stroke by conducting a long-term follow-up.
Using a prospective and longitudinal design, we recruited 421 patients with first-ever acute ischemic stroke who were consecutively admitted to the Acute Stroke Unit between November 2012 and January 2014. Demographic data, vascular risk factors, previous Rankin scale score, and etiology were collected at study intake. Multivariable Cox regression model was used to investigate the influencing factors for RS.
Fifty-seven (13.5%) patients experienced RS during the 1-year follow-up period. Multivariable Cox regression analysis revealed that smoking [hazard ratio (HR), 2.153; 95% confidence interval (CI), 1.263-3.671], high-density lipoprotein cholesterol (HDL) (HR 0.438; 95% CI 0.211-0.911), housework (HR 0.488; 95% CI 0.256-0.933), ischemic heart disease (IHD) (HR 2.998; 95% CI 1.281-7.020), daily consumption of fresh fruits (HR 0.477; 95% CI 0.278-0.819), and good sleep quality (HR 0.375; 95% CI 0.216-0.650) were associated with RS among stroke patients.
Our results suggest that healthy lifestyle (high fruit intake, smoking cessation, housework, and good sleep quality), higher HDL levels, and lack of IHD may be associated with a lower risk of RS in patients with first-onset IS.
既往研究表明,复发性卒中(RS)会对缺血性卒中(IS)幸存者的生活造成不良影响。然而,针对与 RS 相关的生活方式,汉族患者尚未得到系统研究。我们旨在通过长期随访,对汉族首次急性缺血性卒中住院患者进行全面评估,以明确其生活方式和潜在的 RS 相关危险因素。
采用前瞻性、纵向设计,连续纳入 2012 年 11 月至 2014 年 1 月期间入住急性卒中单元的首次急性缺血性卒中患者 421 例。于入组时收集患者的人口统计学资料、血管危险因素、既往 Rankin 量表评分和病因。采用多变量 Cox 回归模型分析 RS 的影响因素。
在 1 年的随访期间,57 例(13.5%)患者发生 RS。多变量 Cox 回归分析显示,吸烟[风险比(HR),2.153;95%置信区间(CI),1.263-3.671]、高密度脂蛋白胆固醇(HDL)(HR 0.438;95% CI 0.211-0.911)、家务劳动(HR 0.488;95% CI 0.256-0.933)、缺血性心脏病(IHD)(HR 2.998;95% CI 1.281-7.020)、每日摄入新鲜水果(HR 0.477;95% CI 0.278-0.819)和良好的睡眠质量(HR 0.375;95% CI 0.216-0.650)与卒中患者的 RS 相关。
本研究结果提示,健康的生活方式(高水果摄入量、戒烟、家务劳动和良好的睡眠质量)、较高的 HDL 水平和无 IHD 可能与首次发生 IS 的患者 RS 风险降低相关。