心电图左室肥厚与脑卒中发病风险及其预后的关系  

Electrocardiographic left ventricular hypertrophy contributes to the risk of stroke and long-term poor prognosis of patients with stroke

作　　者：吴艳[1] 白永怿[1] 张伟丽[2] 孙凯[2] 惠汝太 廖玉华[3] 汪道文[4] 

机构地区：[1]北京协和医学院中国医学科学院阜外医院高血压诊疗中心,北京100037 [2]北京阜外医院心血管病相关基因与临床研究教育部重点实验室(中德实验室) [3]华中科技大学附属协和医院心内科 [4]华中科技大学附属同济医院心内科

出　　处：《临床心血管病杂志》2010年第11期850-853,共4页Journal of Clinical Cardiology

基　　金：国家973重点基础研究发展规划基金(G2006CB503805)

摘　　要：目的:评价在我国人群中心电图左室肥厚对脑卒中(包括动脉粥样硬化性血栓性脑梗死、腔隙性脑梗死、脑出血亚型)发病的风险和脑卒中患者长期心脑血管不良事件发生的风险。方法:采用多中心病例对照研究分析心电图左室肥厚与脑卒中的关系,并对脑卒中患者进行前瞻性随访,利用COX生存回归模型分析左室肥厚对心脑血管不良事件的影响。结果:共1874例初发脑卒中患者和1879例对照入选。在校正了性别、年龄、体质指数、血压、血糖、血脂因素后,心电图左室肥厚显著增加脑卒中发病的风险(P<0.01),脑卒中以及动脉粥样硬化性血栓性脑梗死亚型、腔隙性脑梗死亚型、脑出血亚型校正后的OR值分别是2.2(95%CI:1.6～3.0)、2.2(95%CI:1.6～3.1)、1.8(95%CI:1.2～2.7)、2.0(95%CI:1.3～3.0)。随访0.1～6.1(3.7±1.4)年,在校正了混杂因素后,心电图左室肥厚显著增加脑卒中患者心脑血管不良事件发生的风险(RR:1.36,95%CI:1.04～1.76,P<0.05)。结论:心电图左室肥厚不仅是我国脑卒中患者发病的独立危险因素,而且还是脑卒中患者预后不良的独立预测因素。Objective：To evaluate whether electrocardiographic left ventricular hypertrophy（LVH）contributes to the risk of stroke and long-term prognosis of stroke patients.Method：This is a multi-center case-control study to assess the relationship between LVH and stroke,and then the patients with stroke were followed up annually by standard questionnaire.Cox proportional-hazards models were used to examine the association between LVH and long-term cerebrocardiovascualr adverse events.Result：A total of 1 874 stroke patients and 1 879controls were recruited,after adjustment for sex,age,body mass index and conventional vascular risk factors,LVH was associated with evaluated risk of 2.2-fold（95%confidence interval[CI]1.6-3.0）for overall stroke,2.2-fold（95%CI 1.6-3.1）for cerebral thrombosis,1.8-fold（95%CI1.2-2.7）for lacunar infarction,2.0-fold（95%CI1.3-3.0）for intracerebral hemorrhagea.After a mean follow-up of（3.7±1.4）years,LVH was associated with eval-uated risk of 1.36-fold（95%CI1.04-1.76）for long-term adverse cardiovascular events.Conclusion：LVH is not only an independent risk factor for stroke,but also an independent predictor for poor prognosis of stroke.

关 键 词：心电描记术 左室肥厚 脑卒中 

分 类 号：R540.4[医药卫生—心血管疾病]