老年慢性心房颤动患者发生血栓栓塞性中风的危险因素

目的　探讨老年慢性心房颤动患者发生血栓栓塞性中风的危险因素。方法　对 42 0例 (>6 0岁 )资料完整的慢性心房颤动患者进行统计分析 ,其中发生血栓栓塞性中风 83例 (19.8% ) ;死亡 71例 (16 .9% )。结果　 (1)单变量分析老年慢性心房颤动患者发生血栓栓塞性中风最有意义的危险因素 :高血压、糖尿病、心肌梗死、心力衰竭、左室射血分数降低、胆固醇及甘油三酯增高、高密度脂蛋白降低 (P<0 .0 5 ) 。年龄、性别对血栓栓塞性中风无明显影响 (P >0 .0 5 ) ,胆固醇、甘油三酯与血栓栓塞性中风有明显关系 (P <0 .0 1)。 (2 )Cox回归显示 :高血压、胆固醇水平增高是老年慢性心房颤动患者发生血栓栓塞性中风的独立危险因素。结论　老年慢性心房颤动患者发生血栓栓塞性中风危险因素众多 ;有效控制血压、积极降脂治疗是预防血栓栓塞性中风的关键。

Risk factors for thromboembolic stroke in old patients with chronic atrial fibrillation

Objective To evaluate risk factors for thromboembolic stroke in old patients with chronic atrial fibrillation.Method 420 patients with chronic atrial fibrillation(age>60) were analysed.Of them,83 (19.8%) developed thromboembolic stroke and 71(16.9%) died.Results (1)Univariate analysis showed that significant risk factors for thromboembolic stroke in old patients with chronic atrial fibrillation were hypertension,diabetes mellitus,prior myocardial infarction,history of congestive heart failure,abnormal left ventricular ejection,increased serum total cholesterol and triglyceride and decreased serum high density lipoprotein(P<0.05).Age,sex had no effect on thromboembolic stroke(P>0.05).Serum cholesterol and triglyceride levels were significantly associated with thromboembolic stroke(P<0.01).(2)The Cox's regression model showed that hypertension and increased serum cholesterol level were significantly independent risk factors for thromboembolic stroke in old patients with chornic atrial fibrillation.Conclusion There are many risk factors for thromboembolic stroke in old patients with chronic atrial fibrillation and hypertension and serum cholesterol are the strongest risk factors for thromboembolic stroke in Chinese elderly patients with chronic atrial fibrillation.