Research On Multiple Risk Factors Of Stroke And Changes In Pre-stroke Condition Based On Regional Characteristics

Objective:The purpose of this study is to explore the changes of the condition of patien ts with acute ischemic stroke before onset and the related risk factors,so as to arouse enough attention.Through the early warning function of the basic syndrome elements and clinical ma nifestations presented when the condition changes,we can actively prevent stroke and provide reference for secondary prevention of ischemic stroke.Objects and methods:From April 2014 to May 2017,311 patients with acute ischemic stroke in Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Dongf ang Hospital of Beijing University of Traditional Chinese Medicine and Fangshan Hospital of Beijing University of Traditional Chinese Medicine were enrolled.The patients with acute str oke whose onset time was less than 14 days were studied retrospectively.The basic informati-on of the patients,the changes of the condition before the onset and clinical manifestations,pa st history,dietary habits,biochemical,blood coagulation,blood routine,carotid artery color D oppler ultrasound and other indicators at admission were recorded.SPSS22.0 was used for fre quency and system clustering analysis.Results:1.A total of 311 patients were admitted to the acute stage of ischemic stroke,incl uding 212 males(68.2%)and 99 females(31.8%).The sex ratio between males and females was about 2.1:1.The age group with high incidence of stroke was between 50 and 70 years ol d,with a total of 196 patients(63.0%).From the onset season,except in June,July and Augus t,the number of cases is relatively small,the other months are high incidence season.2.In terms of bad habits and lifestyle,smokers accounted for 53.4%,drinkers accounted for 40.2%,meat-based diet accounted for 54.3%,fat-eating,animal viscera and fried people a ccounted for 23.8%,23.8%,19.6%,respectively.58.2%were salty,38.6%were sweet,28.9%were hot,52.4%were sedentary,sedentary and restful,and 42.4%were irritable.3.In terms of etiological factors,173 patients(55.6%)were able to identify the etiologic al factors.Among them,53 cases were tired,accounting for 30.6%,46 cases were angry or an gry,accounting for 26.6%,33 cases were irregular diet,accounting for 19.1%.4.In the past,hypertension and diabetes accounted for 66.8%and 39.5%of stroke patient s,respectively.Only 25.0%and 25.2%of stroke patients had good control,while 21.3%had blood lipid tests,while Fangshan,located in the suburbs,accounted for only 3.5%.5.Among 202 patients surveyed in Fangshan Hospital of Beijing University of Tradition al Chinese Medicine,84.2%were found to have carotid artery plaques,5.4%were found to have vascular stenosis and 76.7%were unstable plaques.Homocysteine elevation was as high as 70.8%,uric acid abnormality was 23.8%,triglyceride abnormality was 45.5%,cholesterol abnormality was 14.5%,low density lipoprotein was not up to standard was 94.1%.6.The most frequent clinical symptoms of apoplexy were dizziness(46.4%),temporary symptoms(37.9%),dry mouth(30.9%),fatigue(29.6%),sleepiness(29.3%),constipation(29.3%),irritability,restlessness,restlessness(29%),blurred vision(23.5%),chest pain(22.2%),phlegm(19%).Among them,17.7%were sticky,17.7%were slow,17.1%were difficult to eat,16.4%were frequent palpitations,16.1%were bad breath,16.1%were dizziness,14.8%were instant dizziness and 14.5%were unable to eat.The frequency of dizziness and drowsine ss was the highest in 3,7 and 14 days before onset.7.Based on the clinical significance of clinical manifestations and referring to the clinica 1 experience of tutors,the first 17 clinical manifestations with the highest frequency were an-alyzed,and three main symptoms were found:dizziness,fatigue/tiredness and sleepiness,blur red vision/dizziness,chest tightness and chest pain,phlegm and stickiness,slow reaction,sti-ckiness in the mouth,postprandial sleepiness and frequent palpitations.Eating is not enough.Fire and heat are the main syndromes:dry mouth,dry mouth,constipation,irritability/restles sness/restlessness,bad breath,head swelling and so on.Wind pathogen is the main syndrom e:transient symptoms(including sudden walking to one side).According to the analysis of cli nical pathway and treatment plan,wind-phlegm-blood stasis syndrome(55.6%)and wind-fire disturbance syndrome(19.9%)are the common clinical syndromes in our department.8.The correlation between multiple risk factors of stroke and the most common clinical manifestations before stroke onset showed that the situation with statistical significance was chest tightness and chest pain when blood pressure was poorly controlled,dry constipation wh en blood sugar was unstable,and blurred vision/dizzi-nessand bad breath when neck was unst able plaque.Conclusion:1.The age range of ischemic stroke is 50 to 70 years old,and more males than females.The incidence of ischemic stroke is high in winter and spring,which is consiste nt with previous studies.Interventional factors such as smoking,drinking,fat and fat diet,quiet and sedentary lifestyle accounted for a large proportion of patients with ischemic stroke.Suburbs did not pay attention to blood lipid testing,and the importance of blood pressure a nd blood sugar was worrying.In this study,hyperhomocysteinemia and low density lipoprotei n(LDL)were more obvious.Combining with the local people's living habits and dietary pre-ferences,assessing the risk factors of intervention of ischemic stroke can help guide the secon dary prevention of ischemic stroke.2.The most common clinical manifestations before stroke can be divided into windphle-gm syndrome and wind-fire syndrome.The syndrome elements are mainly wind,fire and ph-legm.Following the "preventive treatment" theory of "prevention before illness,prevention of both illness and change",early identification of the characteristics of disease changes,and di-fferentiation of symptoms and signs of multiple risk factors will effectively reduce the occurre nce and recurrence of stroke,improve the quality of life and reduce the economic burden.