| Background and Objectives:Characterized by high incidence, high morbidity, high mortality and highrecurrence rate, acute ischemic stroke have brought heavy burden to patients as wellas their families and the community. Due to the pathogenesis of different subtypes ofcerebral infarction are not the same, for patients who have a history of ischemic stroke,we should conduct risk stratification of risk factors and develop individualizedtargeted prevention and treatment for patients who are at high risk of relapse. To takeeffective preventive measures as soon as possible is the key to prevention of recurrentstroke. The main purpose of this study was to find out the Etiology and subtypedifferences of first and recurrent ischemic stroke through the analysis of the high riskfactors, explore the risk factors associated with recurrent stroke, thereby providing abasis and reference for the individual treatment of cerebrovascular disease in high-riskpopulations.Materials and Methods:Continuous collection499ischemic stroke patients who first visited andhospitalized at the First Norman Bethune Hospital of Jilin University. Detailedrecords of medical history and imaging and laboratory data for all patients and dividethe patients into first stroke group and recurrent stroke group according to frequencyof recurrent stroke, then compare stroke risk factors, etiology and subtypecharacteristics of two groups of patients.Results:1、The first group have the highest incidence in the50-59years old group, andthe recurrent group have the highest incidence in the60-69years old group. Theaverage age of the recurrent group is higher than the first group（58.93±12.20vs.63.03±10.03，p=0.014）. Male incidence rate is twice that of women at both groups,but the gender difference between the two groups is not statistically significant（2.13vs.2.53，p=0.409）.2、The patient who has a history of TIA in the recurrent group are more than thatin the first group（6.28%vs.9.82%，p=0.014）. 3、The prevalence of hypertension of the first group is higher than the recurrentgroup(55.8%vs.24.3%，p＜0.001), as well as the history of smoking. The differencesof the two group in history of diabetes is not statistically significant(22.1%vs.24.9%，p=0.484), but the levels of glycated hemoglobin (7.68±4.03mmol/l vs.6.42±2.56mmol/l,p=0.000) and HbA1c (7.04±1.88%vs.6.40±1.34%，p=0.000) aresignificantly higher than the first group. The level of low-density lipoproteincholesterol in the recurrent group is significantly higher than that in the first group,and the level of high-density lipoprotein cholesterol in the recurrent group issignificantly lower than that in the first group(p=0.008and p=0.006). The level ofhigh-sensitivity C-reactive protein are higher than normal in both groups, and therecurrent group is significantly higher than that in the first group(7.69±19.29mg/L vs.13.62±26.87mg/L, p=0.000). The differences of the two group in history of heartdisease, atrial fibrillation, history of alcohol consumption, dyslipidemia, highhomocysteine, high-sensitivity C-reactive protein and the difference between folicacid and vitamin B12was not statistically significant.4、The admission NIHSS score of the recurrent group is significantly higher thanthe first group(5.29±5.236vs.6.47±6.619，0.001＜p＜0.05).5、The incidence of carotid artery plaque in the recurrence group is higher thanthe first group (72.39%vs.89.18%，p＜0.001). The rate of the artery stenosis and therate of severe stenosis of blood vessels in the recurrent group are significantly higherthan The first group(53.37%vs.67.05%，p=0.003;69.77%vs.48.39%，p=0.005).6、The differences of the two group in TOAST subtypes and Bamford subtypeswere not statistically significant. Bamford type: lacunar infarction is the mostcommon type of onset in both groups(51.23%vs.52.60%). TOAST etiologicalsubtypes: small artery occlusive stroke is of the most common(51.23%vs.52.60%),followed by large artery atherosclerotic stroke(29.45%vs.31.21%).Conclusions:1、The average age of the recurrent group is higher than the first group.2、Thepatient who has a history of TIA in the recurrent group are more than that in the firstgroup.3、In the recurrent group, the levels of glycated hemoglobin and HbA1c aresignificantly higher than the first group.4、The admission NIHSS score of therecurrent group is significantly higher than the first group.5、The incidence of carotid artery plaque in the recurrence group is higher than the first group. The rate of theartery stenosis and the rate of severe stenosis of blood vessels in the recurrent groupare significantly higher than the first group.5、Tn the variety of factors influence therisk of cerebrovascular disease, elevated fasting glucose levels and glycosylatedhemoglobin levels, dyslipidemia, carotid artery plaque and deterioration of vascularstenosis is the high risk factor for stroke recurrence after stroke, therefore in order toreduce stroke recurrence, after the onset of stroke we should actively control bloodsugar, blood lipid and control the progress of stenosis. |
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