心房颤动合并后循环脑梗死患者的临床特点分析  

Clinical features of AF patients with posterior circulation ischemic stroke

作　　者：王光胜[1] 童道明[1] 杨同慧[1] 王元伟[1] 许改红[1] 胡婷[1] 马玉苹[2] 

机构地区：[1]沭阳县人民医院神经内科,223600 [2]江苏省人民医院老年医学科

出　　处：《中华老年心脑血管病杂志》2015年第12期1250-1252,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨心房颤动(房颤)合并后循环脑梗死患者的病变特点及预后。方法选择后循环脑梗死患者172例,根据诊断分为房颤组82例和非房颤组90例,入院后应用弥散加权成像检查确定责任梗死灶,用三维时间飞跃法磁共振血管造影术进行血管病变评估;然后分别记录入院时、3及14d美国国立卫生研究院卒中量表(NIHSS)评分,30和90d使用Barthel指数(BI)进行评分,3个月行改良Rankin量表(mRS)评分。结果与非房颤组比较,房颤组发病年龄明显偏大[(74.5±10.8)岁vs(68.2±9.5)岁,P=0.000],多发梗死灶明显偏多(23.2%vs11.1%,P=0.035),入院时及3dNIHSS评分明显升高,差异有统计学意义(P=0.000,P=0.036)。logistic回归分析显示,入院时NIHSS评分、多发梗死灶、颅内动脉狭窄是预后不良的独立危险因素。结论房颤合并后循环脑梗死患者入院病情重于非房颤患者,但90d预后无差异。Objective To study the clinical features and prognosis of AF patients with posterior circulation ischemic stroke.Methods One hundred and twenty-two patients with posterior circulation ischemic stroke were divided into AF group（n=82）and non-AF group（n=90）.Their vascular lesions were detected by DWI and identified by 3D-TOF MRA,their NIHSS scores were recorded on days 3and 14.The lesions were scored on days 30 and 90according to the Barthel Index（BI）and modified Rankin scale（mRS）respectively.Results The average onset age of AF was significantly older,the percentage of vascular lesions and the NIHSS score were significantly higher at admission and on day 3after admission in AF group than in non-AF group（74.5±10.8years vs 68.2±9.5years,P=0.000;23.2% vs 11.1%,P=0.035）.Logistic regression analysis showed that NIHSS score,infarction foci and intracranial stenosis were the independent risk factors for the poor prognosis of AF patients.Conclusion The condition of AF patients with posterior circulation ischemic stroke is worse than that of non-AF patients.However,no difference is found in their prognosis after 90 days.

关 键 词：心房颤动 脑梗死 磁共振血管造影术 脑缺血 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.75[医药卫生—临床医学]