中文摘要：

目的探讨多个危险因素聚集与急性缺血性脑卒中患者出院结局不良的关系。方法采用回顾性队列研究的方法,连续纳入内蒙古兴安盟人民医院2009年6月1日~2012年5月31日住院急性缺血性脑卒中患者为研究对象,共计3 440例。收集人口统计学、生活方式和实验室检查资料。结局不良定义为患者出院时MRs（Modified Rankin’s scale,MRs）≥3分,结局良好定义为患者出院时MRs≤2分。对结局良好组和结局不良组的急性缺血性脑卒中患者入院时基线资料进行比较。危险因素的分析采用两分类非条件logistic回归方法,计算比值比（Odds ratio,OR）及95%可信区间（95%Confident interval,95%CI）。结果 3 440例患者中有结局不良者359例,发生率为10.44%。单因素非条件logistic分析显示,年龄、体温、高血压病、高血糖、脑卒中病史、吸烟、饮酒、高纤维蛋白原及高甘油三脂9个因素与发生结局不良有关系（P均〈0.05）,其OR（95%CI）分别为1.24（1.12~1.38）、1.89（1.49~2.38）、1.68（1.35~2.10）、1.56（1.24~1.97）、1.59（1.27~2.00）、1.45（1.18~1.77）、1.39（1.13~1.70）、2.37（1.75~3.23）、0.44（0.32~0.62）。在校正了年龄、体温、脑卒中病史、高甘油三脂因素后对其余5种独立危险因素（包括高血压病、高血糖、吸烟、饮酒、高纤维蛋白原）的聚集性分析显示,相对于未暴露于上述危险因素者,暴露于任1~5个上述危险因素和聚集于上述2、3、4、5个均与结局不良发生率有关系,调整后的OR分别为1.659、1.997、3.093、4.854、25.980（P〈0.0001）,趋势性χ2检验表明,随着危险因素聚集个数的增加,急性缺血性脑卒中患者结局不良发生率也随之增高（P〈0.0001）。结论高血压病、高血糖、吸烟、饮酒、高纤维蛋白原5个危险因素聚集可增加急性缺血性脑卒中患者出院结局不良发生率的风险,且存在着剂量反应关系。

英文摘要：

Objective Study the relevance of the gathering multiple risk factors and the adverse out- comes in patients with acute ischemic stroke after discharging from hospital. Methods Totally 3440 consecu- tive patients with acute ischemic stroke from June 1, 2009 to May 31, 2013 treated in Inner Mongolia XingAn- Meng People＇s Hospital were retrospectively cohort analyzed, were Collected demographic, lifestyle and labora- tory data. When discharging from hospital, MRs （Modified Rankin＇s scale, MRs） ～ 3 is defined as adverse outcome. MRs _--〈 2 is defined as good outcome. We compared the baseline data of the patients with acute is- chemic stroke when they were admitted, which were divided into good outcome group and adverse outcome group. The risk factors were anatyzed with binomial logistic regression analysis, odds ratio（OR）and 95 ～ Con- fident Interval（95～CI）were calculated. Results The ratio of adverse outcome was 10. 44%（359/3440）. The univariate logistic analyses showed that there were statistical significance in terms of adverse outcome among age, temperature, hypertension, hyperglycemia, previous stroke, smoking, drinking, high fibrinogen, and high triglycerides（P〈0. 05）. The value of ORs（95%CI） are 1.24（1.12～1.38）, 1.89（1.49～2. 38）, 1.68（1. 35～2. 10）,1.56（1.24～1.97）,1.59（1.27～2. 00）, 1.45 （1.18～1.77）,1.39（1. 13～1.70）,2. 37（1.75～3. 23）and 0. 44（0. 32～0. 62）respectively. The analysis of the gathering of 5 independent risk factors （hyperten- sion, hyperglycemia, smoking, drinking and high fihrinogen）after revising tb_e factors of age, temperature, re- lapse and high triglycerides showed that exposing to any of five risk factors mentioned above or gathering the last four risk factors had relevance to the incidence of adverse outcome. The value of ORs were 1. 659,1. 997, 3. 093,4. 854,25. 980（P～0. 001） after adjusting. The outcome of trend test indicated that the rising incidence of adverse outcome of acute ischemic s