对缺血性脑卒中患者二级预防、卒中风险及日常生活能力的门诊随访调查研究

目的：通过调查及概述本院门诊缺血性卒中患者的医疗现状,评价神经科门诊缺血性卒中患者二级预防中期随访结果,Essen卒中风险评分量表（EsRS）的有效性和可靠性及其与日常生活能力评定（mRS）的相关性。方法：以2010．7至2010．9内新发脑梗死门诊随访患者为研究对象,调查患者基本情况、危险因素、合并用药情况,并进行Essen及mRS评分。1年后随访患者,评价心脑血管终点事件发生率及其与Essen评分的关系。结果：人组102例患者,平均年龄67．4±岁,分别伴有糖尿病、高血压、高脂血症、动脉粥样硬化性疾病,追踪其一年后使用抗血小板药、降压药、降脂药及降糖药的比例。Essen评分与mRS评分呈正向相关关系;EsRS≥3分的患者终点事件发生率显著高于EsRs〈3分的患者。结论：目前缺血性脑卒中的二级预防仍存在药物应用不足、慢性基础疾病控制率低、长期依从性较差等情况。Essen评分可以有效地评估患者发生终点事件的风险以及缺血性脑卒中患者的预后。

Department of internal medicine second hospital affilliated to Chongqing Medical University nerve

Objective：To investigate the medical status of patients with ischemic stroke in outpatient department of our hospital and evaluate the middle- term follow - up results of secondary prevention, validity and reliability of Essen score, and the correlation between Essen score and mRS score of patients with ischemic stroke in neurology outpatient. Methods： During 2010.7 2010.9, the patients with new onset of cerebral infarction within half a year were enrolled to investigate the general information , risk factors and chronic drugs treatment, and to conduete Esscn score and mRS score. The incidence of endpoint events including cebrocardiovascular endpoint events were evaluated and the relationship between endpoint events and Essen score were assessed after 1 - year follow - up. Results： 102 patients were enrolled with an average age of 67.4 years. The patients complicated with diabetes, hypertension, hyperlipidemia, and atherosclerosis disease accotmted for 30.4%, 70.6%, 71.6%, 49% ,respectively.The proportion of proper use of antiplatelet drugs, antihypertensive drugs, lipid - lowering drugs and hypoglycemic therapy were 82.3%, 98.6%, 76.7%, 93.5% , respectively. The proportion of use of autiplatelet drugs, antihypertensive drugs, lipid - lowering drugs and hypoglycemic therapy were 74.5 % ,98.6%, 63 %, 87.1% , respectively after one - year follow - up. A positive correlation was proved between Essen score and mRS score. The incidence of endpoint events in patients with ESRS I〉 3 was significantly higher than that with ESRS 〈 3. Conclusion： The situations such as lack of drug application, low rate of control of underlying chronic disease and poor long - term compliance still exist in the current secondary prevention for ischemic stroke. Also, Essen score can be used as an effective tool for risk evaluatation of the incidence of endpoint events and one of referential criteria in patients with ischemie stroke.