| BackgroundCerebral infarction accounts for about 70% of Chinese’s cerebrovascular disease subtypes.Literature reported the annual recurrence rate of cerebral infarction reaches17.7%.Active secondary prevention is the key strategy to reduce cerebral infarction recurrence.Although some clinical treatments have intervened with traditional risk factors,still lacking researches about risk factors.Therefore,this study selected factors which related to recurrent cerebral infarction(RCI),and screen out highly specific risk factors,to help formulated the secondary prevention and treatment strategies for cerebral infarction.ObjectiveTo explore the risk factors related to cerebral infarction recurrence,and analyze the relationship between these factors and cerebral infarction area,to provide a theoretical basis for secondary prevention of cerebral infarction.MethodsA retrospective study was used to select 221 patients with acute cerebral infarction who were treated in the neurology department of our hospital from February 2019 to August 2019,and were divided into an initial group(n=165)and a relapse group(n=56)according to whether they relapsed.According to head CT or MRI examination to assess the size of infarct area,according to Adamas classification criteria,the recurrence group was divided into large area infarction group(n=10),small area infarction group(n=23)and lacunar infarction group(n= twenty three).According to the NIHSS score,the relapse group was divided into the heavy group(n=5),the medium group(n=31)and the light group(n=20).Collect the baseline and medical records of the research subjects,and perform carotid color Doppler ultrasound examination to determine the presence or absence of plaque and plaque nature.Univariate and multivariate logistic regression analysis were used to screen for risk factors for recurrent cerebral infarction,And the ROC curve was used to analyze the diagnostic value of indicators.Spearman correlation analysis was used to explore the relationship between fibrinogen(FIB)and UA levels and infarction area and severity of disease in RCI patients.Results1.Univariate analysis showed that FIB,UA,homocysteine(Hcy),total cholesterol(TC),carotid plaque formation,regular use of antiplatelet drugs and stability of carotid plaque were statistically significant(all P<0.05).2.Multivariate Logistic analysis showed: FIB(OR=2.635,95%CI: 1.526-4.594)、UA(OR=1.006,95% CI: 1.002-1.010)were independent risk factors for recurrence cerebral infarction(all P <0.05).3.ROC curve analysis results show that the area under the FIB curve is 0.705(0.631-0.780),and the area under the UA curve is 0.662(0.582-0.742),both P<0.05.It shows the clinical diagnostic value of the two indexes is better.4.Spearman correlation analysis was used to further compare the correlation between different infarct sizes and FIB and UA levels in the relapse group.It was found that there was a positive correlation between FIB,UA levels and the size of infarction areas in RCI patients(r = 0.716 and 0.559,both P <0.05).The levels of FIB and UA in the large-area infarction group were significantly higher than those in the small-area infarction group and the lacunar infarction group,and the FIB and UA levels in the small-area infarction group were significantly higher than those in the lacunar infarction group(all P <0.05).5.Spearman correlation analysis was used to further compare the correlation of different severity levels with FIB and UA levels in the relapse group,and found that there was a positive correlation between FIB,UA levels and the severity of RCI patients(r =0.713 and 0.525,all P <0.05).The FIB and UA levels in the heavy group were significantly higher than those in the medium and light groups,and the FIB and UA levels in the medium group were significantly higher than those in the light group(both P <0.05).Conclusions1.FIB,TC,UA,Hcy,carotid plaque formation,unstable plaque,and antiplatelet drugs are associated with recurrence of cerebral infarction.2.Higher FIB/UA level is an independent risk factor for recurrence of cerebral infarction,and it is positively correlated with the infarct size and severity of the patient’s condition. |
