摘要：

目的 筛查缺血性卒中复发危险因素并评估复发风险。方法 采用Essen 卒中风险评分（ESRS）评价176 例缺血性卒中患者（首次发作96 例、复发80 例）复发风险，单因素和多因素逐步法Logistic 回归分析筛查缺血性卒中复发危险因素。结果 缺血性卒中首次发作组与复发组患者年龄和> 75 岁患者比例、高血压、糖尿病、冠心病、周围血管病、短暂性脑缺血发作或缺血性卒中、饮酒、ESRS评分差异具有统计学意义（均P < 0.05）；首次发作组ESRS 评分0 分1 例（1.04%）、1 分8 例（8.33%）、2 分39 例（40.63%）、3 分44 例（45.83%）、4 分4 例（4.17%），复发组ESRS 评分3 分2 例（2.50%）、4 分20 例（25%）、5 分37 例（46.25%）、6 分18 例（2.50%）、7 分3 例（3.75%），组间差异有统计学意义（Z = -11.376，P = 0.000）。Logistic 回归分析显示，仅ESRS 评分> 3 分是缺血性卒中复发的独立危险因素（OR = 31.324，95%CI：3.934 ~ 249.430；P = 0.001）。结论 ESRS 评分> 3 分是缺血性卒中复发的独立危险因素，应加强对缺血性卒中复发风险的评估，筛查并控制危险因素是缺血性卒中二级预防的关键。

关键词: 卒中, 脑缺血, 复发, 危险因素, 回归分析

Abstract:

Objective  To screen the risk factors for recurrence of ischemic stroke and to assess the risk of recurrence.  Methods  Essen Stroke Risk Score (ESRS) was used to evaluate the risk of recurrence in 176 patients with ischemic stroke (96 cases of first onset and 80 cases of recurrence). Univariate and multivariate stepwise Logistic regression analysis was used to screen risk factors for recurrence of ischemic stroke.  Results  There were significant differences between first onset group and recurrence group on age, the proportion of > 75 years old, hypertension, diabetes, coronary heart disease, peripheral angiopathy, transient ischemic attack (TIA) or ischemic stroke, drinking and ESRS score (P < 0.05, for all). First onset group included one case of ESRS 0 (1.04%), 8 cases of 1 (8.33%), 39 cases of 2 (40.63%), 44 cases of 3 (45.83%), 4 cases of 4 (4.17%). Recurrence group included 2 cases of ESRS 3 (2.50%), 20 cases of 4 (25% ), 37 cases of 5 (46.25% ), 18 cases of 6 (22.50% ), 3 cases of 7 (3.75% ). There was significant difference between 2 groups (Z = -11.376, P = 0.000). Logistic regression analysis showed ESRS > 3 score was independent risk factor for recurrence of ischemic stroke (OR = 31.324, 95%CI: 3.934-249.430; P = 0.001).  Conclusions  ESRS > 3 score is the independent risk factor for recurrence of ischemic stroke. It is important to strengthen risk assessment of recurrence of ischemic stroke. To screen and control risk factors is the key to secondary prevention of ischemic stroke.

Key words: Stroke, Brain ischemia, Recurrence, Risk factors, Regression analysis