Abstract:

Objective To explore the relationship between 90 days prognosis of patients with minor stroke and drug compliance. Methods A consecutive patients with minor stroke (NIHSS≤3) hospitalized in Tongji Hospital from August 1, 2014 to July 31, 2015 were enrolled in this study. Drug compliance for stroke secondary prevention, stroke recurrence and modified Rankin Scale (mRS) were investigated by telephone or outpatient service at 90 days after onset. mRS≤2 was defined as good prognosis and mRS>2 was defined as poor prognosis. The chi-square test or Fisher's exact test was used statistically to analyze the early neurological deterioration (END), stroke recurrence within 90 days and the impact of drug compliance on prognosis at 90 day of minor stroke. Results A total of 292 cases were successfully followed up at 90 days after onset. Good prognosis rate (mRS≤2) of minor stroke at 90 days was 81.6%, and recurrence rate was 10.4% within 90 days after onset. END rate was 8.2%. The rate of poor outcomes in END group was higher (58.3%) than no-END group (14.9%, P <0.001). The rate of poor outcomes in the recurrence group was higher (86.7%) than the no-recurrence group other group (6.7%, P <0.001). END and stroke recurrence were closely related to the poor prognosis. The rate of good prognosis of compliance of antithrombotic and hypolipidemic agents were 83.5% and 78.1% respectively. The result showed there was no significant correlation between the bad compliance of stroke secondary prevention and unfavorable outcomes.

Conclusion Minor stroke has good prognosis at 90 days after onset and lower recurrence. END and stroke recurrence are closely related to the poor outcomes of minor stroke at 90 days. There is no significant correlation between the bad compliance of stroke secondary prevention and unfavorable 90-day outcomes.

Key words: Minor ischemic stroke; Outcomes; Early neurological deterioration; Drug compliance

摘要：

目的 探讨轻型卒中90 d预后及与二级预防药物依从性的关系。 方法 连续纳入2014年8月-2015年7月我院神经内科住院的轻型卒中患者，发病90 d时随访其二级预 防药物依从性、卒中复发情况和改良Rankin量表（modified Rankin Scale，mRS）评分。定义mRS评分≤2 分为预后良好，mRS评分＞2分为预后不良，分别用卡方检验或Fisher精确概率法分析早期神经功能恶 化、90 d内卒中复发、用药依从性对轻型卒中90 d预后的影响。 结果 发病90 d时成功随访轻型卒中患者292例，预后良好率为81.6%，90 d内卒中复发占10.4%。轻 型卒中早期神经功能恶化占8.2%，早期神经功能恶化组预后不良率为58.3%，显著高于无早期神 经功能恶化组的14.9%（P＜0.001）。复发组预后不良的比例为86.7%，显著高于无复发组的6.7%（P ＜0.001）。早期神经功能恶化和卒中复发促进不良预后发生。轻型卒中患者90 d内抗血栓和降血脂 药物依从性良好者所占比例分别为83.5%和78.1%，二级预防药物依从性与预后无显著相关。 结论 轻型卒中90 d预后较好、复发率较低。轻型卒中90 d不良预后与早期神经功能恶化及卒中复发 相关；而与二级预防药物依从性无明显相关。

关键词: 轻型卒中; 预后; 早期神经功能恶化; 药物依从性