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Acute ischemic stroke and peripheral arterial occlusion disease related factors
|關鍵字:||Acute ischemic stroke;急性缺血性中風;peripheral arterial occlusion disease;Ankle Brachial Index;周邊動脈阻塞疾病;踝肱指數||出版社:||生命科學院碩士在職專班||引用:||參考文獻 1.行政院衛生署（2010）•九十八年台灣十大死因統計•2010年9月30日，取自http://www.doh.gov.tw/ 2.Criqui MH, Fronek A, Barrett-Connor E, Klauber MR, Gabriel S, Goodman D. The prevalence of peripheral arterial disease in a defined population. Circulation. 1985; 71:510-515. 3.Hiatt WR, Hoag S, Hamman RF. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study. Circulation. 1985; 91:1472-1479. 4.Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004; 110:738-743. 5.Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. 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本研究利用踝肱指數(Ankle Brachial Index¸ABI) 探討急性缺血性中風患者與周邊動脈阻塞疾病(peripheral arterial occlusion disease；PAOD )相關因素。急性缺血性中風住院病人為收案對象，對象限制須為神經缺損症狀產生10天內住院，需經電腦斷層攝影排除出血性中風，總共收案166人，踝肱指數正常（0.91≦ABI≦1.3）128人，踝肱指數不正常（ABI≦0.9）有38人。所有收案病人平均年齡為68.4±9.7歲，男性佔61.4％（n＝102），大於等於65歲以上患者佔66.3％。研究危險因子，有中風病史、高血壓、糖尿病，心臟疾病、抽菸者等。綜合卡方檢定、 Student t檢定、費雪精確檢定（Fisher''s Exact test）與多變項邏輯式分析，結果顯示影響缺血性腦中風合併罹患周邊動脈阻塞疾病最大之變項依序為年齡（勝算比：1.1；95％信賴區間1.0-1.2），空腹血糖（勝算比：1.0；95％信賴區間1.0-1.0），由此知道年齡和空腹血糖是罹患周邊動脈阻塞疾病非常重要因素。埃森中風風險指數（Essen Stroke Risk Score）大於2者其屬再中風高風險，我們病人中，84.2％患者罹患周邊動脈阻塞疾病合併埃森中風風險指數>2 。由以上結果知道缺血性中風患者合併周邊動脈阻塞疾病，易再次發生中風望藉由本次研究，提供另一個預測預後的選項。
We investigate the relationship between peripheral arterial occlusive disease (PAOD) and acute ischemic stroke by ankle brachial index (ABI).The inclusive criteria were the in-patents who suffered from an acuteischemic stroke, and were admitted within 10 days.Ischemic stroke wereconfirmed by brain computed tomography (CT). Among 166 patientscollected, 38 patients had abnormal ABI below 0.9, and the remaining patients were within normal range (0.91 to 1.3). The average age was68.4±9.7 years old, 61.4% were male(n=102)and those who were older than 65 years old was 66.3%. We studied risk factors such as age, previous stroke, hypertension, blood sugar, heart diseases, and smoking.We use Chi-square test, Student t test﹐Fisher''s Exact test and logistic regression. The resultsindicate that the most influential factors are age(Odds Ratio: 1.1; 95％CI) and fasting blood glucose(Odds Ratio: 1.0 ;95％CI). Also, we analyzed these patients using the Essenstroke risk score. The rate of recurrent stroke was highif the score was higher than 2. The data show that the percentage of patients with-in stroke-associated PAOD and high Essen Stroke Risk score was 84.2%. According to these data, patients who suffered from ischemic stroke associated with PAOD are more susceptible to recurrence of stroke.
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