| 李海欣,汪培山,田桂玲,徐卫历,刘东,吴静.脑卒中患者生存率及其影响因素的7年随访研究[J].Chinese journal of Epidemiology,2005,26(9):716-719 |
| 脑卒中患者生存率及其影响因素的7年随访研究 |
| A seven-year follow-up analysis on prognosis factors of stroke patients |
| Received:December 09, 2004 |
| DOI： |
| KeyWord: 脑卒中 随访研究 预后 生存分析 |
| English Key Word: Stroke Follow-up study Prognosis Survival analysis |
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| Abstract: |
| 目的 对脑卒中患者7年随访,描述患者病后生存情况,并分析生存的影响因素。方法 以1995年11月至1996年12月天津医科大学总医院神经内科就诊的脑卒中新发病例189例为研究对象,随访患者的复发、死亡及其他结局。整个随访工作2003年10月完成。应用Kaplan-Meier法进行生存率分析。应用Cox比例风险模型对影响患者生存与复发的因素进行单因素和多因素分析。结果 随访期间,共82例患者死亡,其中因脑卒中(包括首发与复发)死亡58例,因心脏病死亡8例。患者1年生存率为79.86%,3年生存率为65.46%,7年生存率为57.46%。影响患者生存的主要因素有:年龄(RR=1.065,P<0.001),首次发病前参加体育锻炼(RR=0.308,P<0.001),既往有高血压病史(RR=1.785,P<0.05)和脑卒中病史(RR=2.493,P<0.001),与病情严重程度有关的因素如脑损害面积(RR=1.031,P<0.001);患者的生存情况还与出院时情况,以及出院后的康复与治疗、复发情况有关系;研究还发现,社会心理因素诸如对康复有无信心、病后有无压抑感与负面生活刺激、亲友帮助等因素对于患者的生存也有作用。结论 既往有高血压病史与脑卒中病史,发病时脑损伤情况严重对于脑卒中患者的生存影响较大;发病前坚持锻炼,出院后坚持康复与治疗者预后好;复发患者生存率比未复发者低;社会心理因素对生存影响也有较大作用。 |
| English Abstract: |
| Objective To describe survival conditions of patients with stroke and to analyze the factors associated with survival,a seven-year follow-up study was carried out. Methods From Nov. 1995 to Dec. 1996,189 stroke patients were selected in the Department of Neurology,General Hospital,Tianjin Medical University. Cases were followed up since the onset of stroke. Data collected would include case history, illness and survival conditions. Kaplan-Meier methods were used for survival description. Cox regression was used for prognostic factors analyses. Results A total number of 82 patients had been dead during the period of study and among them,58 cases died from stroke. The survival rate was 79‘86% in one year, 65.46% in three years and 57.46% in seven years. Factors with statistical significance that associated with survival would include： age (RR = 1.065, P< 0.001), physical exercises before stroke (RR = 0? 308,P<0.001),hypertension history(RR = 1 ? 785,P<0.05) and stroke history(RR = 2? 493, 0.001) while factors associated with severity of the illness were： area of cerebral lesion, conditions when discharged from the hospital’rehabilitative treatment of post-discharge and recurrence. We also found that social-psychical factors as rehabilitative confidence, repression, negative event, support from relatives and friends were related to survival of stroke. Conclusions Histories on hypertension, stroke and brain injury condition were related to the rate survival on stroke. Patients persisting physical exercises before stroke had better prognosis. The survival rate of patients with recurrence was lower than those without while social psychic factors might be related to survival. |
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