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目的评价门诊危险因素暴露者的卒中风险及脑安胶囊预防卒中的效果。方法在2005~2007年秦皇岛军工医院门诊患者中,选择具有高血压、心脏病、糖尿病、脂代谢紊乱、肥胖和中风家族史等卒中危险因素暴露者(1500例),采用有多普勒探头和压力传感探头的脑血管血流动力学监测仪进行颈动脉脑血管血流动力学检测和危险因素的调查,按知情同意的原则,在血流动力学积分值(CVHI)<75分者中选择278例作为干预对象,并随机分为2组(脑安胶囊组132例,对照组146例),脑安胶囊组在健康教育、指导危险因素治疗等一般干预措施的基础上,口服脑安胶囊(CVHI积分值<50分者,脑安胶囊2粒/次,2次/d,其中积分值<25分者,睡前再加服1粒;积分值50~74分的个体,脑安胶囊1粒/次,2次/d。),对照组仅给予一般干预措施,卒中发生率每6个月随访1次,共随访2年。结果1500例门诊患者中,高血压、心脏病、糖尿病、卒中家族史和肥胖的暴露率分别为36.7%(550/1500)、22.4%(336/1500)、19.5%(292/1500)、9.9%(148/1500)和27.6%(414/1500),血流动力学积分值<75分者占50.7%,脑安胶囊干预组和对照组的2年卒中累积发生率分别为2.3%(3/132)和7.5%(11/146),P=0.0767,脑安胶囊组干预后,CVHI≥50分者由55.6%上升到88.2%,对照组由64.38%上升至84.93%(P<0.01)。结论医院门诊常见危险因素暴露者中,卒中风险明显升高;脑安胶囊能改善脑血管血流动力学,降低卒中的发生率。
Objective To evaluate the risk of stroke in outpatients exposed to risk factors and the effect of Na’an Capsule in preventing stroke. Methods A total of 1500 outpatients with stroke risk factors such as hypertension, heart disease, diabetes, dyslipidemia, family history of obesity and stroke were selected from outpatients in Qinhuangdao Military Hospital from 2005 to 2007. A Doppler probe and Pressure sensor probe of cerebral vascular hemodynamic monitoring of carotid artery hemodynamics and risk factors in the investigation, according to the principle of informed consent, hemodynamic integral (CVHI) <75 points A total of 278 cases were selected as subjects and randomly divided into 2 groups (132 in Naan Capsule group and 146 in control group). On the basis of general intervention such as health education and guidance of risk factors treatment, Capsule (CVHI score <50 points, 2 capsules / capsule, 2 times / d, of which the integral value <25 points, plus 1 bedtime before; points 50 to 74 points in the individual, the brain of Capsule 1 / time, 2 times / d.) The control group was given only general interventions, the incidence of stroke was followed up every 6 months for a total of 2 years. Results The exposure rates of hypertension, heart disease, diabetes, family history of stroke and obesity in 1500 outpatients were 36.7% (550/1500), 22.4% (336/1500), 19.5% (292/1500), 9.9 % (148/1500) and 27.6% (414/1500) respectively. The hemodynamic integral value <75 was 50.7%, and the cumulative incidence of 2-year stroke in both brain capsule and control group was 2.3% (3 / 132), 7.5% (11/146) and P = 0.0767, respectively. After intervention with Naoyan capsule group, the percentage of patients with CVHI≥50 increased from 55.6% to 88.2%, while the control group increased from 64.38% to 84.93% (P <0.01) . Conclusions Among the risk factors of hospital outpatients, the risk of stroke is significantly increased. Na’an Capsule can improve cerebral blood flow hemodynamics and reduce the incidence of stroke.