老年缺血性脑卒中患者按牛津郡社区脑卒中规划临床分型与预后的关系

目的探讨老年缺血性脑卒中患者按牛津郡社区脑卒中规划(OCSP)临床分型及其与预后的关系。方法采用回顾性队列研究的方法,对208例老年缺血性脑卒中患者按照OCSP临床分型并进行随访,分析各亚型与复发和死亡的关系。结果OCSP各亚型构成比分别为完全前循环脑梗死占10.6%,部分前循环脑梗死占24.0%,后循环脑梗死占4.3%,腔隙性脑梗死占61.1%。各亚型的复发率无统计学差异,完全前循环脑梗死1年病死率(63.6%)显著高于其他3型(P<0.05)。OCSP临床分型(HR=1.91,95%CI:1.09~3.34)、有并发症(HR=4.04,95%CI:1.52~10.76)和格拉斯哥昏迷评分低(HR=3.79,95%CI:1.24~11.63)是缺血性脑卒中患者死亡的主要危险因素。结论OCSP临床分型可以为缺血性脑卒中患者的预后判断提供参考依据。

The relation between OCSP subtypes and the prognosis in the elderly patients with ischemic stroke

Objective To study the relation between Oxfordshire Community Stroke Project classification(OCSP) subtypes and the prognosis in the elderly patients with cerebral infarction.Methods Using retrospective cohort study,208 patients with cerebral infarction were followed up and classified by OCSP as TACI,PACI,POCI and LACI.The relation between OCSP subtypes and the death and recurrence of cerebral infarction was analyzed.Results The composition of OCSP subtypes was TACI 10.6%,PACI 24.0%,POCI 4.3%,and LACI 61.1%.There was no relation between OCSP subtypes and the recurrence of cerebral infarction.The fatality rate of TACI was 63.6% and significantly higher than other subtypes.Cox's proportional hazard regression model showed that the risk factors associated with mortality were OCSP subtypes(HR=1.91,95%CI:1.09-3.34),having complication(HR=4.04,95%CI:1.52-10.76)and low Glasgow scores(HR=3.79,95%CI:1.24-11.63).Conclusion OCSP subtypes can be used to predict the prognosis of patients with cerebral infarction.