The Study On Stroke's Incident And Risk Factors For Early Warning

Objective To investigate all kinds of its risk factors'value in early warning the incident (of stroke) and provide evidences for diagnosing and therapying stroke by analyzing 1000 stroke patients'clinical data and auxiliary examinations Methods 1.Collecting the clinical date and laboratory examination results of 1000 stoke patients in the department of internal neurology of Changhai Hospital from March,2004 to March,2007,including 677 males and 322 females. The age range from 45 to 89, and the average age is (67.19±11.55).800 patients with ischemia stroke ,180 patients with hemorrhagic stroke and 20 patients with both of them.847 patients with hypertension(HBP),323 patients with diabetes mellitus(DM) and 307 patients with hyperlipemia.873 patients with chest distress, panicky and chest pains before. 266 patients with cardiac disease, of these 201 with coronary artery disease (CAD) ,48 with atrial fibrillation (AF) and 17 with rheumatic valvular disease.395 with smoking history,290 with drinking history and 331 patients with stroke before. 101 patients has familial history of 52 with hypertensive disease and 49 with stroke. All the patients have both blood and urina auxiliary examination data, head CT exam results and complete case histories. 850 patients had underwent the abdominal ultrasonic inspection. 300 patients had underwent the echocardio–graphy. 290 patients had underwent the carotis ultrasonic inspection. 133 patients had underwent the artery of lower extremity ultrasonic inspection. 2. The clinical data of 300 patients(including 147 males and 153 females) homochronous in hospital who haven't got stroke has been collected as control group.Age range from 45 to 92 and the average age is (63.37±11.78). 3.Both the clinical and the auxiliary examination data are integrated. The clinical data include, the name, age, sexuality, the history of smoking,drinking,HBP,DM,hyperlipemia and cardiac disease.,familial history diseases and the laboratory examine results(including the cholesterol total, triglyceride, high density lipoprotein, low density lipoprotein, lipoprotein ,creatinine, uric acid, dextrose) and some patients'imaging exam results(the head CT,MRI and the ultrasonic inspection of abdominal,cartoid,cardiac and the artery of lower extremity). 4. Statistic analysis:first,building up the Excel database.Second,using statistic software to analyze the data.Use T test, X2 test and multivariant logisticgradual regressive analysis to statistical analysis all the two groups'data. Results 1. There is no significant statistics disparity on age and sexuality between the two groups.2.Patients with hypertension, diabetes mellitus and hyperlipoidemia in the stroke group were more than that in the control group and their instantaneous blood pressure(BP),blood fat and blood glucose level are all higher than normal, especially patients with HBP, DM and hyperuricacidemia(HUA)history, their risks of stroke were more serious.(1)The patients'instantaneous BP had increased especially the systolic blood pressure(SBP),which 30mmHg higher than normal. Both the hypertension duration and the BP extent has related to stroke.The risk of cerebrovascular disease is 3~5 times higher in patients with HBP and HUA than those with normal uric acid.(2) Many factors,such as age, sexuality,blood glucose level and the DM duration,have related to DM patients who also get stroke .Patients with higher level and longer DM duration were more sucepted to stroke and this phenomenon were happen in females.The number of patients with DM and HUA in stroke group is much more than those who with normal uric acid. This consequence suggested that the risk of stroke increasing when DM patients'uric acid turn to be abnormal.(3)Some hyperlipoidemia patients'blood fat level has been out of control in a long term, when they get HBP or DM at the same time, the risk of happening stroke become higher and the time come earilier. Many of those patients'stroke had poor prognosis. Some patients are easy to happen recurrent attacks. 3. There is significant differences in the comparation on the laboratory examine results (including the blood glucose, cholesterol total, triglyceride, high density lipoprotein, low density lipoprotein, creatinine, uric acid, dextrose,аlipoprotein) between stroke group and control group.Lower HDL and higher LDL is the predictor of stroke. 4.The number of smoker and alcohol users in stroke group is more than that in control group. Positive correlation can be found between the risk of stroke and smoking index number to the patients with HBP,DM and artherosclerosis(AS),their stoke happen significantly ahead of schedule. 5.Patients with familial hypertensive disease and familial stroke in stroke group are more than that in control group. 6.Color Doppler ultrasonography results:(1) carotid artery ultrasound: The control group: a large number of patients'diameter(D) of CCA are normal, few patients'intimal-medial thickness(IMT)get a little thicker. The incidence rate of plaques in control group is 10.7% and many of them are small and single. These plagues'echo is strong and many of them have acoustic shadow. Resistance index of blood flow are all in normal range, only few number of patients'RI become a little higher. The stroke group:290 stroke patients'D become widen and the IMT of CCA obviously gets thicker than that in control group, a number of patients'lining endothelium is crude. The incidence rate of plaques is 80%. (2) US(ultrasonic cardiogram):The control group: left ventricle contractile function are all in the normal range,52.8% patients'left ventricle diastolic function decrease, three patients'basal segment of inter ventricular septum(IVS)are thicker than normal, all the patients'left ventricle posterior wall (LVPW) thickness are normal, the mycrdium normokinesia extent is in common. The stroke group: The ECG of those patients who complained of chest distress, panicky, left thorax frontal area pains before are different from normal. The shape of left ventricle is increasing irregularity, the LVPW thickness is uneven. Some patients'basal segment of IVS and left ventricle lateral wall, inferior wall and posterior wall has turn to be thinner. The mycrdium hypokinesis myokinesis extent has become weaken or uncoordinated. Left ventricle contractile and diastolic function are all decreased. Color display mild to moderate mitral regurgitation (MR) on period of contraction.(3) Abdomen Ultrasound: There are 850 stroke patients having hepar adiposum and many patients having cholecystolithiasis. The incidence rate of kidney cystic in stroke group is higher than that in control group (31.6% VS 18.3%). Conclusion 1. Stroke is a common disease which do severity harm to mankind's health and life. It can be caused by many kinds of risk factors. This study has retrospectively analyzed 1000 stroke patients'clinic data and auxiliary examination results. Hypertension, diabetes mellitus , hyperlipemia, HUA and unhealthy living habits(such as a long term of smoking and drinking) have been classified as the main risk factors that leading to stroke. All these high risk factors not only have their respective pathopoiesia feature but also interact together to accelerate the progress of affection. Finding out all the risk factors and recognizing the forerunner affection characters in time , can reduce both the incidence rate and recrudescence rate of stroke'. Color Doppler Ultrasound can discover the pathological hang of cerebral vessels promptly. It also has great value in predicting stroke'occurrence and development, so 2D-CDUS has been considered to be one of the most important examination methods of stroke.