缺血性脑卒中患者院内首次发现心房颤动危险因素分析  

Risk factors of atrial fibrillation first detected in the hospital in patients with ischemic stroke

作　　者：杨琴[1] 邓学军[1] 罗贵全 余冬梅[1] Yang Qin;Deng Xuejun;Luo Guiquan;Yu Dongmei(Cardiac Electrophysiology Room,Cardiovascular Center,Suining Central Hospital.Suining,629000,China)

机构地区：[1]四川省遂宁市中心医院心血管中心,629000

出　　处：《心脑血管病防治》2021年第3期248-250,257,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨缺血性脑卒中患者院内首次发现心房颤动风险的相关因素。方法选取2014年6月至2019年6月于遂宁市中心医院确诊为缺血性脑卒中的患者为研究对象共511例,根据院内首次发现心房颤动149例,为房颤组,余362例为对照组,比较两组患者的临床资料、化验检查指标及心电图特征等情况并进行回归分析。结果房颤组年龄、脑卒中史及美国国立卫生研究院卒中量表(NIHSS)评分、左心房直径与对照组比较差异具有统计学意义(t/χ~2=3.331、4.650、2.250、2.248,P<0.05)。房颤组P波离散度、P波电轴、正常连续窦性RR间期差值均方根(RMSSD)、相邻RR间期差值大于50 ms百分比(PNN50)、低频谱功率/高频谱功率比值(LF/HF)与对照组比较差异有统计学意义(t=2.540、4.448、3.388、2.659、10.188,P<0.05)。Logistic回归分析显示,年龄、NIHSS评分、左心房直径、P波离散度、P波电轴及LF/HF均为心房颤动的危险因素[OR(95%CI)=1.028(1.010~1.045)、1.085(1.027~1.146)、1.134(1.028~1.250)、1.024(1.003~1.045)、1.082(1.036~1.130)、2.340(1.333~4.107),P<0.05]。结论LF/HF、P波离散度及P波电轴与缺血性脑卒中患者院内首次发现心房颤动有一定相关。Objective To investigate the risk factors for atrial fibrillation first detected in the hospital in patients with ischemic stroke.Methods A total of 511 patients diagnosed with ischemic stroke in Suining Central Hospital from June 2014 to June 2019 were selected as subjects,149 cases with atrial fibrillation were included in atrial fibrillation group,and the rest 362 cases were the control group.Clinical data,laboratory examination indexes and electrocardiograph characteristics of the two groups were compared and logistic regression analysis was conducted.Results Age,stroke history,the National Institutes of Health Stroke Scale(NIHSS)score and left atrial dimension in atrial fibrillation group were significantly different from those in control group(t/χ2=3.331,4.650,2.250,2.248;P<0.05).P wave dispersion,P wave axis,root mean square of successive differences in RR intervals(RMSSD),percent of the number whose difference between adjacent NN interval are more than 50 ms(PNN50)and low frequencies/high frequencies(LF/HF)in atrial fibrillation group were statistically different from those in the control group(t=2.540,4.448,3.388,2.659,10.188;P<0.05).Logistic regression analysis showed that age,NIHSS score,left atrial dimension,P wave dispersion,P wave axis and LF/HF[OR(95%CI)=1.028(1.010~1.045),1.085(1.027~1.146),1.134(1.028~1.250),1.024(1.003~1.045),1.082(1.036~1.130),2.340(1.333~4.107);P<0.05]were risk factors of atrial fibrillation.Conclusion LF/HF,P wave dispersion and P wave axis are related to the risk of atrial fibrillation first detected in the hospital.

关 键 词：缺血性脑卒中 心房颤动 心率变异性 P波离散度 P波电轴 

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]