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Objective To investigate the impact of acute cerebral infarction patients 3 months prognosis, relapse rate and mortality of cardiovascular disease-related factors, the effect of prevention and treatment evaluation of risk factors for the management of three functional prognosis patients with cerebral infarction and cardiovascular and cerebrovascular disease recurrence rate. Methods February 2010 to December 2010, the Department of Neurology of our hospital inpatient age 35 to 84 years with acute cerebral infarction patients for the study, the patient's general condition, clinical information, and nervous system function score registration. During hospitalization for individuals with risk factors and unhealthy lifestyles, health education of patients. Up for 3 months (± 7 days), follow-up, detailed records of compliance within 3 months after the onset of the patient's risk factors for intervention, whether recurrence and functional recovery (modified Rankin Scale score), evaluation of the effects of interventions. General, including gender, age, risk factors (hypertension, diabetes, hyperlipidemia, atrial fibrillation, myocardial infarction, and stroke / TIA history), lifestyle (smoking, drinking); clinical information including the lesion site, TOAST points type, OCSP typing and the admission of the relevant laboratory tests (blood count, coagulation, liver and kidney function, blood lipids, electrolytes and glucose, etc.). Nervous system function score by the U.S. National Institutes of Health Stroke Scale NIHSS (NIH Stroke Scale score), rated by trained professionals enrolled patients. 1.3 months, cardiovascular and cerebrovascular disease recurrence rate was 4.36%; cardiovascular disease mortality rate was 7.26%; survival and relapse-free patients with a poor prognosis patients accounted for 31.12%. Women, elderly patients (60-84 years old) with poor prognosis and higher risk (P lt; 0.05). 3. Elderly patients on admission to be female than male, the average age of women. Women and elderly patients with a higher incidence of atrial fibrillation (P lt; 0.05); elderly patients with previous stroke / TIA history of a higher incidence (P lt; 0.05); young and middle-aged patients with hyperlipidemia incidence higher (P lt; 0.05). 4 lesion site in patients with lesions in basal hypothalamus area the most common (22.70%). 5. TOAST typing to large artery atherosclerosis (77.59%), which TOAST classification for other reasons in the proportion of women than men, small artery occlusion in the proportion of young and middle-aged group than the older group ; OCSP typing partial anterior circulation accounted for the majority (56.02%); to which OCSP classification for partial anterior circulation in the proportion of women than men. 6 women and elderly patients on admission NIHSS score average score higher (P lt; 0.05). Lesion site located in the cerebral hemispheres, the frontal lobe, parietal lobe, insula, temporal lobe and multiple lesions of patients with poor prognosis (P lt; 0.05). Lesion site is located in the cerebral hemispheres, the high mortality of patients three months of the basilar artery and bilateral lesions (P lt; 0.05); lesion site is located in the basal ganglia of patients with three-month mortality lower (P lt; 0.05) . Not found in the lesion site and recurrence (P gt; 0.05). TOAST type in the main artery of a higher incidence of poor prognosis of atherosclerosis in patients with cerebral infarction (85.33%), followed by cardiogenic cerebral embolism (10.67%), small artery occlusion in patients with cerebral infarction incidence of poor prognosis than low (4.00%), the difference was statistically significant (P lt; 0.05). Higher mortality in patients with cardiogenic cerebral embolism (34.78%), followed by large-artery atherosclerosis (5.28%), the difference was statistically significant (P lt; 0.05). Cardiogenic cerebral embolism patients may have a higher risk of recurrence (P gt; 0.05). OCSP typing in part of the anterior circulation lesions in patients with a higher incidence of poor prognosis (64.00%), followed by the posterior circulation (29.33%), lacunar lesions in patients with poor prognosis lowest incidence (4.00%), the difference was statistically significance (P lt; 0.05). Partial anterior circulation patients may have a higher risk of recurrence and mortality risk (P gt; 0.05). 10. Before the cycle and / or posterior circulation stenosis poor prognosis rate was significantly higher (P lt; 0.05). Anterior circulation and posterior circulation stenosis higher risk of recurrence (P lt; 0.05). Vascular stenosis or not has nothing to do with the three-month mortality risk (P gt; 0.05). 11 have high blood pressure, stroke / TIA patients with a history of three months of poor prognosis (P lt; 0.05). Its three-month high mortality risk in patients with a history of atrial fibrillation (P lt; 0.05). 12 admission blood tests elevated LDH, elevated neutrophil higher incidence of poor prognosis in patients with elevated blood urea (P lt; 0.05). Higher risk of recurrence in patients with reduced total protein (P lt; 0.05). Blood urea increased direct bilirubin higher mortality rate (P lt; 0.05). Good prognosis group (P lt; 0.05) were significantly higher than the body temperature of the non-performing group, systolic blood pressure, heart rate, respiratory rate of 13. Prognosis. Death group, systolic blood pressure, and heart rate were significantly higher than the survival group (P lt; 0.05). NIHSS score of 14.3 months of follow-up in the field of vision items overlooked items admission, the difference was not statistically significant (P gt; 0.05); each of the other 3 months when ratings are low, the difference was statistically significant ( P lt; 0.05). 15 patients enrolled in hypertension awareness rate of 78.99%; diabetes awareness rate of 87.50% to 41.95%; hyperlipidemia awareness. 16 smoking cessation in patients with poor prognosis incidence was significantly higher than not smoking cessation in patients with P lt; 0.05. Blood pressure recurrence rate of the control group (8.43%) blood pressure was significantly higher than the control group (2.88%), P lt; 0.05. Further analysis by age group shows the young group hypertension control by a lower incidence of adverse prognosis elderly group of ex-smokers have a higher incidence of poor prognosis (P lt; 0.05). Blood sugar management and alcohol and the 3-month prognosis and recurrence independent of (P gt; 0.05). 17. Patient admission NIHSS score significantly higher than ex-smokers have quit. Conclusion 1. 3 months after the onset of cerebral infarction in patients with heart and cerebrovascular disease recurrence rate was 4.36%; case fatality rate of 7.26%; alive and accounted for 31.12% of patients with a poor prognosis in patients with no recurrence. Lesion sites (cerebral hemispheres. Poor prognosis with three functions related factors are gender, age, history of hypertension, stroke / TIA history, blood tests elevated LDH, elevated neutrophils, elevated blood urea frontal lobe, parietal lobe, insula, temporal lobe), multi-infarct lesions, imaging examination cycle and / or circulating narrow, vital signs (elevated body temperature, systolic blood pressure, increased heart rate, respiratory rate faster) . 3 and 3 months recurrence related factors reduce the total protein of the blood tests, imaging examinations anterior circulation and posterior circulation stenosis. Factors associated with 3-month mortality history of atrial fibrillation, blood tests and blood urea increased direct bilirubin, lesion site (cerebral hemispheres, the basilar artery), bilateral lesions, vital signs (systolic blood pressure increased faster heart rate). Lower mortality of patients with lesions in the basal ganglia area. 5. TOAST typing better predict prognosis and mortality of 3 months. Better predict the role of the OCSP classification on the three-month prognosis. The three-month follow-up the NIHSS score breakdown horizons items and neglect has no significant improvement. 7 into the group of patients with hypertension, diabetes and hyperlipidemia awareness were lower. 8 within three months after the infarction control blood pressure levels (lt; 140/90mmHg) can effectively reduce the recurrence rate within three months, the young and middle-aged patients with poor prognosis can effectively reduce the rate. 9. Smoking cessation patients, especially in old age group smoking cessation in patients with poor prognosis, may be admitted to hospital with the patient, the severity of the disease heavier related.
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