不同类型非瓣膜病性心房颤动并发缺血性脑卒中临床风险比较

目的研究非瓣膜病性心房颤动（房颤）患者中持续性房颤与阵发性房颤患者发生急性缺血性脑卒中的临床风险比较。方法将343例脑卒中患者分为重症（NIHSS评分≥22分），轻症（NIHSS评分≤8分），再将重症患者分为持续性房颤组、阵发性房颤组与非房颤组。轻症患者同样分组，进行临床资料分析。结果重症患者中房颤发生总例数明显增多，较非房颤差异有统计学意义，其中，持续性房颤组与阵发性房颤组比较差异无统计学意义。轻症患者中，非房颤例数明显增多，较房颤组差异有统计学意义，持续性房颤组与阵发性房颤组比较差异有统计学意义。在脑卒中危险因素中，D-二聚体及纤维蛋白原房颤患者较血栓形成脑卒中差异有统计学意义。结论房颤易造成大面积脑梗死，且病情危重，阵发性房颤与持续性房颤同样具有高风险，应得到及时有效的预防措施。

A comparison of acute cerebral infarction in patients with different nonvaivular atrial fibrillation

Objectives To evaluate the risks of acute cerebral infarction in patients with different nonvalvular atrial fibrillation (nvAF).Methods We reviewed the clinical presentations,CT or/and MR,UCG,in 343 consecutive hospitalized acute cerebral infarction patients.Patients were divided into severe groups (NIHSS ≥20) and mild groups(NIHSS≤8).Severe group patients were further divided into three subgroups:group persistent atrial fibrillation,paroxysmal atrial fibrillation and non atrial fibrillation.Mild group patients were divided into similar three subgroups.The patients'clinical data were inquired.Statistical analysis were performed using t-test and ANOVA.Results The total rate of AF in severe group was higher than that of non AF group (P<0.05),while persistent atrial fibrillation and paroxysmal atrial fibrillation were similar (P>0.05).In mild group,the total rate of non AF was higher(P<0.01),and rate of persistent atrial fibrillation was higher than that of paroxysmal atrial fibrillation (P<0.01).In common stroke risk factors.the nunlerical value of D-dinner and Fbg of atrial fibrillation were higher (P<0.01). Conclusion The cerebral infarction in patients with nvaf was common,which with large area cerebral infarction and high rate of hospitalized death.The high cerebral infarction risk of paroxysmal atrial fibrillation was same as persistent atrial fibrillation.