【摘要】 目的了解脑梗死合并颈动脉硬化住院患者随访1年的生存情况及影响因素,为延长患者生存期、降低死亡率提供循证依据。方法纳入2017年4月—2018年8月于南华大学附属长沙中心医院收治的脑梗死合并颈动脉硬化住院患者548例并随访1年,根据其生存情况分为存活组与死亡组,对两组的临床特征进行比较,采用Cox比例风险回归模型分析影响其生存状况的因素。结果 548例患者随访期内共死亡36例,死亡率约6.57%。单因素分析结果显示婚姻状况、文化水平、心脏病、年龄以及甘油三酯是脑梗死合并颈动脉硬化住院患者随访期内死亡的危险因素(P<0.05)。多因素Cox比例风险回归模型分析显示,婚姻状况(无配偶)(HR 1.736,95%CI 1.086～2.776)、心脏病(HR 2.343,95%CI 1.156～4.752)增加脑梗死合并颈动脉硬化住院患者死亡风险,文化水平高(HR 0.205,95%CI 0.044～0.952)降低其死亡风险。结论无配偶、文化水平低及患有心脏病的脑梗死合并颈动脉硬化住院患者具有更高的死亡风险。出院后,家属要加强对无配偶及患有心脏病的脑梗死合并颈动脉硬化患者的综合照护及人文关怀,以降低其死亡风险。更多还原

【Abstract】 Aim To investigate the survival status and influencing factors of hospitalized patients with cerebral infarction complicated with carotid atherosclerosis for 1-year follow-up, so as to provide evidence-based basis for prolonging the survival period and reducing the mortality rate. Methods From April 2017 to August 2018, 548 inpatients with cerebral infarction and carotid atherosclerosis admitted to Changsha Central Hospital Affiliated to University of South China were enrolled and followed up for 1 year. According to their prognosis, the patients were divided into survival group and death group. The clinical characteristics of the two groups were compared. Cox proportional hazards regression model was used to analyze the factors affecting the survival status of the patients. Results Among 548 patients, 36 patients died during the follow-up period, with a mortality rate of 6.57%. Univariate analysis showed that marital status, education level, heart disease, age and triglyceride were the risk factors of death in patients with cerebral infarction and carotid atherosclerosis during the follow-up period(P<0.05). Multivariate Cox proportional hazards regression model analysis showed that marital status(no spouse)(HR 1.736, 95% CI 1.086-2.776), heart disease(HR 2.343, 95% CI 1.156-4.752) increased the risk of death in hospitalized patients with cerebral infarction and carotid atherosclerosis, and high education level(HR 0.205, 95% CI 0.044-0.952) reduced the death risk. Conclusions The hospitalized patients with cerebral infarction and carotid atherosclerosis with no spouse, low education level and heart disease have higher death risk. After discharge, the family members should strengthen the comprehensive care and humanistic care for the patients with cerebral infarction and carotid atherosclerosis who have no spouse or have heart disease, so as to reduce the risk of death.更多还原