无瓣膜病变心房纤颤患者缺血性脑卒中相关因素研究

Clinical Analysis of Relationship between Ischemic Stroke and Atrial Fibrillation without Pathology of Valve and Relevant Factors

目的探讨NVAF患者缺血性脑卒中相关危险因素,评估CHADS2评分预测卒中风险的准确性.方法选择收治并确诊的82例发生缺血性脑卒中的无瓣膜病变心房纤颤患者为病例组,未发生缺血性脑卒中的无瓣膜病变心房纤颤患者82例为对照组.结果与未发生缺血性脑卒中的无瓣膜病变心房纤颤患者相比,缺血性脑卒中无瓣膜病变心房纤颤患者的各项危险因素均明显增高P<0.05;除心衰、高血压、年龄>75岁、糖尿病、脑卒中等传统危险因素外,体重指数超高、冠心病、嗜酒、高脂血症、左房面积扩大及左心室舒张功能降低等因素均致使缺血性脑卒中的风险增高P<0.05.结论 NVAF患者缺血性脑卒中的发病不仅与CHADS2评分上各项危险因素相关,且与体重指数超高、冠心病、嗜酒、高脂血症、左房面积扩大及左心室舒张功能降低等因素亦有密切关系,应针对相关危险因素积极进行治疗,以达到降低缺血性脑卒中发病率的目的.

Objective To investigate the risk factors for the ischemic stroke in the atrial fibrillation patients without the pathology of valve,then evaluate the clinical applied value of embolism risk score（CHADS2） on the ischemic stroke.Methods Based on clinical manifestations,laboratory examinations,82 cases that were damaged by the ischemic stroke were selected as case group and the same patients without the ischemic stroke were selected as control group,and the relative parameters were analyzed between the groups.Results All of the values of risk factors were significantly higher in case group than those in control group（P0.05）.In addition to traditional risk factors（heartfailure,hypertension,diabetes,up 75 years,stroke）,adiposity,coronary disease,alcoholism,hyperlipidemia,left atrial expansion,ventricular diastolic function reducing also increased the risk of ischemic stroke（P0.05）.Conclusions Traditional and new risk factors had played important roles in the ischemic stroke and the atrial fibrillation without the pathology of valve.The treatment should be focused on the risk factors,in order to reduce the incidence rate of stroke.