非瓣膜性心房颤动患者脑卒中危险因素的研究

目的:探讨非瓣膜性心房颤动(NVAF)患者脑卒中的危险因素。方法:选择2002-01至2009-01在我院住院的NVAF患者1064例,按NVAF有无合并脑卒中分为NVAF无脑卒中组(n=924)和NVAF合并脑卒中组(n=140)。结果:1064例患者NVAF脑卒中的检出率为13.2%。NVAF合并脑卒中组的≥75岁年龄者、既往高血压史及肝功能不全的发生率、纤维蛋白原、甘油三酯、总胆固醇比NVAF不合并脑卒中组升高,而左心室射血分数(LVEF)降低,异常均有统计学意义(P<0.05)。多元素非条件Logistic回归分析:≥75岁高龄、高血压、左心室射血分数、纤维蛋白原、甘油三酯、总胆固醇均与脑卒中显著相关(P<0.05)。结论:患者高龄(≥75岁)、高血压、纤维蛋白原、甘油三酯及总胆固醇为NVAF合并脑卒中的独立危险因素,而左心室射血分数为NVAF合并脑卒中的保护因素,左心室射血分数越高患者越不易发生房颤。

The Risk Factor Analysis for Stroke in Patients With Non-Valvular Atrial Fibrillation

Objective:To study the risk factors for stroke in patients with non-valvular atrial fibrillation(NVAF). Methods:A total of 1064 NVAF patients≥75 years of age treated in our hospital from 2002 to 2009 were retrospectively analyzed.The patients were divided into two groups as NVAF+stroke+ group,n=140 and NVAF+stroke-group,n=924.The related risk factors for stroke were studied and compared between two groups. Results:The prevalence rate of stroke in NVAF patients was 13.2%(140/1064).The patients in NVAF+stroke+ group presented the elder age,more history of hypertension,more damaged liver function,they also had increased blood levels of fibrinogen,triglyceride and total cholesterol,while decreased left ventricular ejection fraction(LVEF)than those in NVAF+stroke-group,P<0.05 respectively.Multivariate logistic regression analysis indicated that the elder age,hypertension,LVEF,fibrinogen,triglyceride and total cholesterol were closely related to stroke P<0.05 respectively. Conclusion:The elder age(≥75 years),hypertension,increased blood levels of fibrinogen,triglyceride and total cholesterol were the independent risk factors for stroke in NVAF patients.While elevated LVEF level could be considered as the protective factor for NVAF+stroke+.The patients with higher LVEF would have less chance for suffering from AF.