老年人非风湿性心房颤动伴发缺血性脑卒中的相关因素分析  

Relationship of stroke with nonrheumatic atrial fibrillation in elderly patients

作　　者：缪东培[1] 何述莉 吕磊[1] 徐军[1] 

机构地区：[1]南京军区南京总医院心内科,江苏南京210002 [2]江苏省军区第四干休所,江苏南京210028

出　　处：《中华保健医学杂志》2009年第1期12-14,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的研究老年人非风湿性心房颤动(NRAF)的临床特点和NRAF伴发缺血性脑卒中的相关因素。方法回顾性分析240例NRAF老年患者的心电图、超声心动图、颈动脉彩色多普勒超声、头颅CT或磁共振等检查及临床资料。结果卒中组高血压的患病率高于非卒中组(69.39%vs52.36%,P<0.05);卒中组糖尿病合并高血压的患病率高于非卒中组(22.45%vs10.47%,P<0.05);持续性房颤患者卒中的发生率高于阵发性房颤者(24.82%vs14.14%,P<0.05);颈动脉有粥样硬化斑块者卒中的发生率高于无斑块者(26.26%vs10.53%,P<0.05);在119例轻度左房增大(内径31～40mm)患者中,二尖瓣返流(MR)者卒中发生率显著低于无MR者(4.76%vs26.53%,P<0.05)。结论老年人NRAF伴缺血性脑卒中的独立危险因素包括:高龄、高血压、颈动脉粥样硬化斑块、糖尿病合并高血压和持续性房颤,轻度左房增大伴MR的NRAF患者缺血性脑卒中发生率较低。Objective To evaluate clinical feature and relationship of stroke with nonrheumatic atrial fibrillation （NRAF）in elderly patients. Methods 240 elderly patients of NRAF were retrospectively analysized. Univariate and multivariate analyses were assessed in electrocardiogram, transthoracic echocardiography, carotid artery of color Dopper nhrasonography, head CT （or magnetic resonance imaging）and other clinical data. Results Incidence of hypertension in group of stroke was higher than that in group of non-stroke（69.39% vs 52.36% ,P〈0.05）. Incidence of stroke in the group of persistent atrial fibrillation （AF）was higher than that in the group of paroxysmal AF（24.82% vs 14.14%,P〈0.05 ）. And the group with carotid artery plaques has the higher incidence of stroke than the group without plaques（26.26% vs 10.53%,P〈0.05）. There are more diabetes mellitus with hypertension patients in the group of stroke than those in the group of non-stroke（22.45% vs 10.47% ,P〈0.05 ）. In 119 patients with slightly increased atrail diameters（31-40 mm）,the incidence of stroke in the group with mitral regurgitation （MR）was lower than that in the group without MR （4.76% vs 26.53%,P〈0.05 ）. Conclusions Advanced age, hypertension, atherosclerosis plaques in carotid artery;diabetes mellitus with hypertension and persistent AF were independent risk factors in elderly NRAF with ischemic brain stroke, In AF patients with slightly increased atrail diameters, MR reduces the incidence of stroke.

关 键 词：心房颤动 缺血性脑卒中 高血压 二尖瓣返流 

分 类 号：R541.75[医药卫生—心血管疾病]