中国中医院非心源性缺血性脑卒中患者的发病及复发特点

Yang GAO; Yan-ming XIE; Gui-qian WANG; Ye-feng CAI; Xiao-ming SHEN; De-xi ZHAO; Ying-zhen XIE; Yin ZHANG; Fan-xing MENG; Hai-qing YU; Jun-jie JIANG; Rui-Li WEI

doi:10.1007/s11655-022-3306-4

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中国中医院非心源性缺血性脑卒中患者的发病及复发特点

Original Article | Updated：2022-06-27

- 中国中医院非心源性缺血性脑卒中患者的发病及复发特点
- Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospitals
- Chinese Journal of Integrative Medicine 2022年28卷第6期页码：492-500
- Affiliations：
  
  1.Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing (100700),China
  2.Department of Rehabilitation, Dongfang Hospital,Beijing University of Chinese Medicine, Beijing (100078), China
  3.Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing (100010),China
  4.Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou (510120), China
  5.Department of Neurology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou (450000),China
  6.Department of Neurology, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun(130017), China
  7.Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing(100700), China
  8.Department of Neurology, Taiyuan Hospital of Traditional Chinese Medicine, Taiyuan (140107), China
- Author bio：
  
  Prof. XIE Yan-ming, E-mail: ktzu2018@163.com
- Funds：
  
  Traditional Chinese Medicine Research Special Project(201507003-8);Construction of a Service System for Traditional Chinese Medicine Preventive Treatment of Disease(2018YFC1704705)
- DOI：10.1007/s11655-022-3306-4
  中图分类号：
- 纸质出版日期：2022-06-01，
  
  网络出版日期：2022-03-08，
  
  录用日期：2021-05-16
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Yang GAO, Yan-ming XIE, Gui-qian WANG, 等. 中国中医院非心源性缺血性脑卒中患者的发病及复发特点[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500.

Yang GAO, Yan-ming XIE, Gui-qian WANG, et al. Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospitals[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500.
Yang GAO, Yan-ming XIE, Gui-qian WANG, 等. 中国中医院非心源性缺血性脑卒中患者的发病及复发特点[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500. DOI： 10.1007/s11655-022-3306-4.

Yang GAO, Yan-ming XIE, Gui-qian WANG, et al. Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospitals[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500. DOI： 10.1007/s11655-022-3306-4.

摘要

目的:

描述中国非心源性缺血性脑卒中患者的发病和复发特征.

方法:

在2016年 11月3日至2019年2月17日期间

本研究对7个临床中心的2558例患者进行了前瞻性、多中心的注册登记研究. 使用问卷调查收集包括中医证候、体质及卒中相关的影响因素

研究的主要结局指标为卒中复发.

结果:

共有327例 (12.78%) 患者出现复发事件. 男性1681例 (65.72%)

平均年龄为63.33±9.45岁; 1741 (68.06%) 例患者为首次缺血性卒中; 1772 (69.27%) 例患者患有高血压病

1640 (64.11%) 例患者存在血脂异常

1595 (62.35%) 例患者卒中病因TOAST分型为小动脉闭塞性. 中医气虚体质为1271例 (49.69%) 、血瘀体质为1227例 (47.97%) ; 中医证候辨证为血瘀证为1303例 (50.94%) 、痰湿证为1280例 (50.04%) 、气虚证为1012例 (39.56%) . 1033 (40.38%) 例患者颅内动脉处于狭窄状态

478 (18.69%) 例患者颈动脉处于狭窄状态; 1508 (41.36%) 例患者的颈动脉斑块为混合型; 41.09% 的人群糖化血红蛋白水平 (HbA1c) 处于异常状态.

结论:

卒中复发在小动脉闭塞性卒中中不能被忽视; 高血压、血脂异常、HbA1c异常、颅内动脉狭窄和颈动脉斑块在脑卒中患者中更为常见; 痰湿证、血瘀证及气虚体质、血瘀体质仍是脑卒中的主要表现.

Abstract

Objective:

To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China.

Methods:

A prospective

multicenter and registry study was carried out in 2

558 patients at 7 representative clinical sub-centers during November 3

2016 to February 17

2019. A questionnaire was used to collect information of patients regarding CM syndromes and constitutions and associated risk factors. Additionally

stroke recurrence was defined as a primary outcome indicator.

Results:

A total of 327 (12.78 %) patients endured recurrence events

681 (65.72%) patients were men

and the average age was 63.33±9.45 years. Totally 1

741 (68.06%) patients suffered first-ever ischemic stroke

772 (69.27%) patients reported to have hypertension

and 1

640 (64.11%) of them reported dyslipidemia

595 (62.35%) patients exhibited small-artery occlusion by The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Specifically

271 (49.69%) patients were considered as qi-deficient constitution

and 1

227 (47.97%) patients were determined as stagnant blood constitution. There were 1

303 (50.94%) patients diagnosed as blood stasis syndrome

280 (50.04%) patients exhibited phlegm and dampness syndrome and 1

012 (39.56%) patients demonstrated qi deficiency syndrome. And 1

033 (40.38%) patients declared intracranial artery stenosis

and 478 (18.69%) patients reported carotid artery stenosis. The plaque in 1

508 (41.36%) patients were of mixed. Particularly

41.09% of them demonstrated abnormal levels of glycated hemoglobin (HbA1c) levels.

Conclusions:

Recurrence in minor and small-artery stroke cannot be ignored. Hypertension

dyslipidemia

abnormal HbA1c

intracranial artery stenosis and carotid plaque were more common in stroke patients. Particularly

phlegm-dampness and blood stasis syndromes

as well as qi deficiency and blood stasis constitutions

were still the main manifestations of stroke. (Trial registration at ClinicalTrials.gov

No. NCT03174535)

关键词

Keywords

noncardiogenic ischemic strokeChinese medicine hospitalonset characteristicsrecurrence

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