北京地区非瓣膜病心房颤动患者缺血性脑卒中发生率及影响因素的随访研究

A follow-up study of incidence of stroke and risk factors in patients with nonvalvular atrial fibrillation in Beijing area

目的 调查分析北京地区心房颤动 (房颤 )患者缺血性脑卒中的发生率及其影响因素。方法 对单一中心的 5 2 0例非瓣膜病房颤患者进行随访调查 ,男 346例 ,女 174例 ,入选年龄 4 0～ 10 2(71 2± 12 2 )岁 ,平均随访 (6 75± 4 0 3)年 ,累计随访 32 2 7人年。结果 该组房颤患者脑卒中的年发生率平均为 5 3%。房颤患者各年龄段的脑卒中发生率 :<6 0岁为 1 2 % (95 %可信区间 0 6 7%～1 73% ,合并危险因素者 1 6 % ,不合并危险因素者 1 0 % ) ;6 0～ 70岁为 4 0 % (95 %可信区间 3 38%～4 6 2 % ,合并危险因素者 5 1% ,不合并危险因素者 3 1% ) ;71～ 80岁为 6 7% (95 %可信区间5 96 %～ 7 4 4 % ,合并危险因素者 8 8% ,不合并危险因素者 4 0 % ) ;>80岁为 7 8% (95 %可信区间6 75 %～ 8 85 % ,合并危险因素者 7 7% ,不合并危险因素者 7 9% )。房颤患者脑卒中的发生率与高血压、糖尿病、脑卒中史等危险因素呈正相关 (P值均小于 0 0 5 )。结论 北京地区非瓣膜病房颤患者非抗凝状态下年缺血性脑卒中发生率为 5 3% ;高龄及合并高血压、糖尿病或缺血性脑卒中史为其发生缺血性脑卒中的危险因素。

Objective To investigate the incidence of stroke and risk factors in patients with nonvalvular atrial fibrillation (AF) in Beijing area Methods This study enrolled 520 consecutive nonvalvular AF patients (male 346, female 174; inpatients 318, outpatients 202) from a single center, with a mean age of (71 2±12 2) years (ranging from 40 to 102) The mean follow up period was (6 75±4 03)years The cumulated follow up were 3 227 person years Results (1) The stroke incidence was 5 3% in AF patients in Beijing area (2) The yearly stroke incidence was 1 2% (95% CI 0 67%-1 73%) in patients <60 years (with risk factor 1 6% and without risk factor 1 0%); 4 0% (95% CI 3 38%-4 62%) in patients 60-70 years (with risk factor 5 1% and without risk factor 3 1%); 6 7% (95% CI 5 96%-7 44%) in patients 70-80 years (with risk factor 8 8% and without risk factor 4 1%); 7 8% (95% CI 6 75%-8 85%) in patients >80 years (with risk factor 7 7% and without risk factor 7 9%) Hypertension, diabetes and ischemic stroke history had a positive correlation with incidence of AF related stroke ( P = 0 000?1, 0 010?1 and 0 012?4, respectively) Conclusions The ischemic stroke incidence in patients with nonvalvular AF in Beijing area was 5 3% yearly Hypertension, diabetes and ischemic stroke history were risk factors of ischemic stroke in these patients