刘华 周原吉 夏云 唐海艳 赵璇 蒋雅璇 陈晓媚 霍春暖

[摘要] 目的 探究腦卒中患者的危险因素和探究脑卒中患者的一级预防方法，为疾病的临床治疗及护理提供参考。 方法 选择2016年2月～2017年2月解放军总医院（以下简称“我院”）神经内科收治的脑卒中患者80例作为病例组，同期选择在我院就诊的非脑卒中患者100例为对照组。通过查阅文献设定疾病发生相关的因素：常规体检、吸烟、过量饮酒、饮食不当、腰臀比过大、体育锻炼、精神压力及抑郁、与子女维持正常沟通、社会交往正常、高血压病、糖尿病、有基础心脏疾病、高脂血症。对两组患者中出现相关因素的情况进行病例对照研究，采用比值比（OR）和卡方检验对相关评价项目进行差异性比较；结合病例对照分析的研究结果，进一步进行暴露因素与是否患病的Logistic回归分析。 结果 两组患者常规体检、社会交往正常、糖尿病、高脂血症差异无统计学意义（P > 0.05），而其他因素差异均有统计学意义（P < 0.05）。Logistic回归分析结果显示，体育锻炼和与子女的正常沟通是保护因素（P < 0.05），吸烟、过量饮酒、饮食不当、腰臀比过大、精神压力及抑郁、高血压病、有基础心脏疾病是脑卒中的危险因素（P < 0.05）。 结论 吸烟、过量饮酒、饮食不当、腰臀比过大、精神压力及抑郁、高血压病、有基础心脏疾病为脑卒中发病的危险因素，根据发病原因可以找出脑卒中患者的一级预防方法。

[关键词] 脑卒中；病例对照；一级预防

[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0164-04

[Abstract] Objective To explore the risk factors of patients with stroke and the primary prevention methods， in order to provide references for the clinical treatment and nursing. Methods From February 2016 to February 2017， in Department of Neurology， Chinese PLA General Hospital （"our hospital" for short）， 80 stroke patients were selected as cases group， at the same period， 100 non-stroke patients were selected as control group. Through literature review made possible factors associated with the disease： routine physical examination， smoking， excessive alcohol consumption， improper diet， excessive waist-to-hip ratio， physical exercise， mental stress and depression， normal communication with children， normal social interaction， hypertension， diabetes， basic heart disease， hyperlipidemia. The case-control study was conducted on the occurrence of related factors in the two groups， and the difference comparison was made using the odds ratio （OR） and chi-square test； combined with the results of case-control analysis， further exposure factors and Logistic regression analysis were performed. Results There was no statistically significant difference between the two groups in routine physical examination， normal social intercourse， diabetes and hyperlipidemia （P < 0.05）， while there were significant differences in other factors （P < 0.05）. The results of Logistic regression analysis showed that physical exercise， normal communication with their children were protective factors （P < 0.05）， and smoking， excessive alcohol consumption， improper diet， excessive waist-to-hip ratio， mental stress and depression， hypertension， and underlying heart disease were risk factors （P < 0.05）. Conclusion Smoking， excessive alcohol consumption， improper diet， excessive waist-to-hip ratio， mental stress and depression， hypertension， and underlying heart disease are risk factors for stroke. The primary prevention method for stroke patients can be found according to the cause of the disease.

[Key words] Patients with stroke； Case-control study； Primary prevention

近年来，随着人们生活水平的提高，不良饮食习惯、作息方式、生活习惯和环境污染等问题导致各种疾病高发[1-2]。各种心脑血管疾病成为危险人类健康的重点疾病，其中脑卒中疾病对个人以及家庭带来的经济和心理负担越来越重，特别是该病的发病近年来逐渐年轻化，对社会造成的影响更加严重[3-4]，如何做好一级预防，降低此类疾病的发病率和致残率，同时提高患者预后的生存率和生活质量成为亟待解决的问题。关……