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老年小动脉闭塞患者的预后及相关因素。

Prognosis and Associated Factors among Elderly Patients with Small Artery Occlusion.

机构信息

Department of Cell Biology, Harbin Medical University, Harbin, 150081, China.

Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.

出版信息

Sci Rep. 2019 Oct 25;9(1):15380. doi: 10.1038/s41598-019-51671-2.

Abstract

Small artery occlusion (SAO) is the one of the primary subtype of ischemic stroke in China. However, its outcomes among elderly patients are unclear. Consecutive patients with SAO were recruited at Jiamusi University First Hospital, China between January 2008 and December 2016. Stroke subtype, severity, and risk factors were collected; outcomes at 3, 12, and 36 months after stroke onset were assessed. A total of 1464 SAO patients were included in this study. Participants aged ≥75 years had higher dependency rates than Participants aged <75 years with SAO in all three follow-up periods, in addition to a higher recurrence rate at 12 months and a higher mortality rate 36 months after stroke. After adjusting for confounders, elevated triglyceride level was found to be a protective factor against mortality 36 months after stroke. Stroke severity, diabetes mellitus, artery stenosis, gender, obesity, and high-density lipoprotein cholesterol level were independently associated with the risk of dependency; elevated triglyceride level was an independent risk factor for recurrence at 3 months point after stroke onset. These findings suggest that it is vital to manage risk factors that may affect prognosis of stroke among elderly patients with SAO to improve patient prognosis and reduce the burden of stroke in China.

摘要

小动脉闭塞(SAO)是中国缺血性脑卒中的主要亚型之一。然而,其在老年患者中的结局尚不清楚。本研究连续纳入 2008 年 1 月至 2016 年 12 月在中国佳木斯大学第一附属医院就诊的 SAO 患者。收集患者的卒中亚型、严重程度和危险因素,评估卒中发病后 3、12 和 36 个月的结局。共纳入 1464 例 SAO 患者。在所有三个随访期内,年龄≥75 岁的患者比年龄<75 岁的患者的依赖性更高,12 个月时的复发率更高,36 个月时的死亡率更高。校正混杂因素后,发现甘油三酯水平升高是卒中发病后 36 个月死亡率的保护因素。卒中严重程度、糖尿病、动脉狭窄、性别、肥胖和高密度脂蛋白胆固醇水平与依赖性风险独立相关;甘油三酯水平升高是卒中发病后 3 个月时复发的独立危险因素。这些发现表明,对于老年 SAO 患者,管理可能影响预后的危险因素对于改善患者预后和减轻中国卒中负担至关重要。

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