无瓣膜病变心房纤颤并脑卒中的临床分析

目的:为完善CHADS2评分指标以提高其预测卒中风险的准确性,为无瓣膜病变心房纤颤患者缺血性脑卒中的防治提供相关依据。方法:采用病例对照研究方法,对600例无瓣膜病变心房纤颤患者进行统一的心血管流行病学调查分析,探讨无瓣膜病变心房纤颤患者缺血性脑卒中相关危险因素。结果:与未发生缺血性脑卒中的无瓣膜病变心房纤颤患者相比,缺血性脑卒中无瓣膜病变心房纤颤患者的各项危险因素均明显增高。使用华法林和阿司匹林后脑卒中风险均有不同程度降低。结论:与传统高危因素相比,体重指数超高、冠心病、吸烟、饮酒、高脂血症、既往血栓栓塞病史、左室射血分数45%、左房面积扩大、左心室舒张功能降低等因素均可使卒中风险增加。

Clinical Analysis the ischaemic stroke in the non- valvular atrial fibrillation

Objective To investigate the relevant risk factors of the ischaemic stroke in the non- valvular atrial fibrillation and provide theoretical basis for the prevention and control. Methods In this case- control study on 600 patients,we studied the risk factors of the ischaemic stroke in the atrial fibrillation patients,and evaluated the embolism risk score（ CHADS2） on the ischaemic stroke and improved its accuracy. Results Among the 600 cases with non- valvular atrial fibrillation,145 patients（ 24. 2%） suffered from the ischaemic stroke. The ischaemic stroke has a higher prevalence among the patients with traditional risk factors. Conclusion Comparing to traditional risk factors,obesity,coronary disease,smoking,alcoholism,hyperlipidemia,left atrial expansion and ventricular diastolic function reducing increased the risk of ischaemic stroke as well.