高血压合并房颤患者卒中危险因素的分析

Analysis of Risk Factors of Stroke in the Patients with Hypertension Combined with Atrial Fibrillation

目的：探讨高血压合并房颤患者随访2年的卒中发生率及其危险因素。方法：分析高血压合并房颤患者资料，根据2年随访事件中是否发生卒中分为卒中组和非卒中组。用单因素和多因素Cox回归模型分析影响高血压合并房颤患者卒中发生的独立危险因素。结果：入选568例高血压合并房颤患者，其中卒中组53例，非卒中组515例，2年卒中发生率为9．3％。卒中组年龄显著高于非卒中组（P〈0．01）；卒中组女性、既往卒中史所占比例均高于非卒中组（P〈0．05）；非卒中组接受抗高血压、抗凝、他汀类药物治疗比例均高于卒中组（P〈0．05）；多因素Cox回归模型分析显示，年龄（HR=1．044，95％C11．011～1．077）、女性（HR=1．893，95％C11．169～3．121）、未接受抗高血压治疗（HR=1．966，95％CI1．009～3．801）、既往卒中史（HR=l.679，95％C11．073～2．614）是高血压合并房颤患者2年卒中发生的独立危险因素。结论：年龄、女性、未接受抗高血压治疗和既往卒中史是高血压合并房颤患者2年卒中发生的独立危险因素。

OBJECTIVE： To explore the independent risk factors of the stroke for 2 years in the patients with hypertension （HT） combined with atrial fibrillation （AF）. METHODS ： Data of HT and AF patients were retrospectively analyzed. The 568 patients were divided into the stroke group （n = 53 ） and the non -stroke group （n = 515 ） according to the results of 2 year follow -up. The predictors of the stroke event for 2 years were identified by uni - and multi - variate Cox regression analysis with the baseline and therapeutic variables. RESULTS ： The incidences of stroke event for 2 years were 9. 3 %. Compared with the non - stroke group, in the stroke group there were more female patients （ P 〈 0.05 ）, the patients were older （ P 〈 0.01 ） and had higher proportion of previous history of stroke （P 〈0. 01 ）. More patients received the antihypertensive treatment, anticoagulation treatment and statins therapy in the non - stroke group （ P 〈 0. 05 ）. Multi - variate Cox regression analysis showed that age （ HR = 1. 044, 95% CI1.011 - 1. 077 ）, male （HR = 1. 893, 95% CI1. 169 - 3. 121 ）, previous stroke history （ HR = 1. 679, 95% CI1. 073 - 2. 614）, and no antihypertensive treatment （ HR = 1. 966, 95% CI1. 009 - 3. 801 ） were independent risk factors for the 2 year stroke event in the patients with HT and AF. CONCLUSION ： Age, female, previous stroke history and no antihypertensive treatment are the independent risk factors for the 2 year stroke event in patients with HT and AF.