脑卒中患者心脏导管术后再发急性脑血管意外分析

探讨既往患有脑卒中的患者行心脏导管术（CC）后再发脑血管病的特点以及相关因素分析。方法对892例实施了CC术的既往患有脑卒中的患者进行回顾性分析,通过对患者的一般状况、心脏血管病变数量、分布、治疗情况以及出现再发脑卒中的情况和相关因素进行分析。结果术中和术后24h内101例患者出现脑卒中,占11．32％,33例出现短暂脑缺血发作（TIA）,64例发生了急性脑梗死（CI）,4例并发脑出血（CH）。Logistic回归分析显示脑血管患者CC术后再次出现急性脑血管意外的危险因素包括：男性、饮酒,高脂血症、患有外周血管病、心脏血管病变的数量以及治疗方法有关。结论脑血管患者CC术后再次出现急性脑卒中的危险因素包括：男性、饮酒,高脂血症、患有外周血管病、心脏血管病变的数量以及治疗方法。

Cerebral vascular accidents after cardiac catheterization in patients with anamnesis of stroke

OBJECTIVE: To investigate the risk factors of relapse of cerebral vascular accident (CVA) after cardiac catheterization (CC) in patients with anamnesis stroke. METHODS: The clinical data of 892 patients with anamnesis stroke who received cardiac catheterization (CC) from Jan. 2002 to Oct. 2006, 555 males and 337 females, aged 61 +/- 10, were analyzed retrospectively. RESULTS: 101 of the 892 patients (11.32%) suffered from CVA during the procedure of CC or within 24 hours after the operation, including 33 cases of transient ischemic attack (TIA), 64 cases of cerebral infarction (CI) and 4 cases of cerebral hemorrhage (CH). Logistic regression analysis showed that the risk factors of relapse of CVA after CC included male gender (OR = 0.308, 95% CI = 0.141 - 0.674), alcohol consumption (OR = 0.319, 95% CI = 0.128 - 0.797), hyperlipidemia (OR = 3.676, 95% CI = 1.94 - 6.950), peripheral vascular diseases (OR = 7.419, 95% CI = 2.477 - 22.219), and number of cardiac vascular diseases (OR = 1.809, 95% CI = 1.284 - 2.548). The patients undergoing percutaneous transluminal coronary angioplasty (PTCA) and stenting were much more liable to CVA compared with the other patients. CONCLUSION: The risk factors of relapse of CVA after CC include male gender, alcohol consumption, hyperlipidemia, peripheral vascular diseases, number of cardiac vascular diseases, and the procedures of PTCA and stenting.