| Objective:To explore the related factors of stroke recurrence in high-risk patients with non-disabling ischemic cerebrovascular events within 1 year,and to provide the basis for secondary prevention.Methods : A total of 353 patients with high-risk non-disabling ischemic events admitted to the department of neurology of the first affiliated hospital of China medical university from September 2017 to October 2018 were prospectively collected.The general clinical data and imaging data of the two groups were collected for retrospective analysis,and the risk factors related to the recurrence of ischemic stroke were analyzed by univariate analysis and logistic regression.Results : 1.Among the 353 patients enrolled who met the inclusion criteria,248(70.3%)were males and 105(29.7%)were females,and the 1-year recurrence rate of stroke was 9.6%.2.The control group with an average age of 64.7±11.59 years old,male 223 cases(69.9%),smoking141 cases(44.2%),drinking 102 cases(32.%),high blood pressure 197 cases(61.8%),diabetes 102 cases(32%),59 cases of coronary heart disease(18.5%),13 cases of atrial fibrillation(4.1%),multiple lesions in 120cases(37.6%),intracranial or extracranial artery atherosclerotic stenosis in 186 cases(58.3%),leukoaraiosis 284 cases(89%),190 cases of brain atrophy(59.6%),There were 72 cases(22.6%)of lacunar with possible vascular origin,238 cases(74.6%)of perivascular clearance,6.63±2.54 of FBG(mmol/l)and 3.02±0.99 of LDL-C(mmol/l).Relapse group of average age 60.41±14.23 years old,male 25 cases(73.5%),10 cases(29.4%),smoking,drinking in 5 cases(14.7%),29 cases of hypertension(85.3%),13 cases of diabetes(38.2%),coronary heart disease(CHD)6 cases(17.6%),2 cases of atrial fibrillation(2.3%),multiple lesions of 20 cases(58.8%),intracranial or extracranial artery atherosclerotic stenosis,28 cases(82.3%),leukoaraiosis 27cases(79.4%),19 cases of brain atrophy(55.9%),There were 16 cases(47.1%)of lacunar with possible vascular origin,25 cases(73.5%)of enlarged perivascular clearance,and the mean value of fasting blood glucose(mmol/l)was 7.16±3.13,and the mean value of LDL-C(mmol/l)was 3.1±0.86.3.Single-factor analysis showedthat in the relapse group,alcohol consumption(P=0.037),hypertension(P=0.007),multiple lesions(P=0.016),intracranial or extracranial atherosclerotic stenosis(P=0.006),and lacunae with possible vascular origin(P=0.002)were higher than in the control group,with statistically significant differences(P < 0.05).4.Logistic regression analysis showed that hypertension(OR=3.86,95%CI: 1.252-11.901,P=0.019),multiple lesions(OR=2.933,95%CL: 1.271-6.767,P=0.012),intracranial OR extracranial atherosclerotic stenosis(OR=3.297,95%CI: 1.179-9.220,P=0.023),and lacunae with possible vascular origin(OR=3.070,95%CI: 1.269-7.427,P=0.013)were independent risk factors for recurrence of ischemic stroke.Conclusions:1.Patients with 1 year high risk of recurrence of ischemic stroke with alcohol consumption,hypertension,multiple lesions,intracranial or extracranial atherosclerotic stenosis of the large arteries,and lacunae that may be vascular origin.2.Hypertension,multiple lesions,intracranial or extracranial atherosclerotic stenosis,and lacunae that may be of vascular origin are independent risk factors for 1-year recurrence of ischemic stroke in patients with high-risk non-disabling ischemic cerebrovascular events. |
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