非瓣膜性房颤患者继发出血性脑梗死的危险因素分析

Analysis of risk factors for secondary hemorrhagic infarction in patients with non-valvular atrial fibrillation

目的分析非瓣膜性房颤患者继发出血性脑梗死(HI)的独立危险因素。方法抽取2013年11月至2016年12月西安医学院第二附属医院收治的113例非瓣膜性房颤患者为研究对象,将29例继发HI患者设为HI组,84例未继发HI患者设为对照组。分析非瓣膜性房颤患者继发HI的独立危险因素。结果HI组合并糖尿病、合并高血压、发生脑栓塞、梗死累及皮质及大面积脑梗死人数均多于对照组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,糖尿病、高血压、梗死类型、部位、面积均为非瓣膜性房颤患者继发HI的独立危险因素(P<0.05)。结论糖尿病、高血压病史、脑栓塞、梗死累及皮质及大面积脑梗死均会增加非瓣膜性房颤患者继发HI的风险,临床实际可根据患者是否具备上述危险因素及早制定对应干预措施,以最大程度降低非瓣膜性房颤患者继发HI的风险,从而保证疾病整体治疗效果,改善患者预后效果。

Objective To investigate the independent risk factors for hemorrhagic infarction (HI) in patients with non-valvular atrial fibrillation. Methods A total of 113 patients with non-valvular atrial fibrillation admitted in the Second Affiliated Hospital of Xi'an Medical University from November 2013 to December 2016 were selected as the study objects. A total of 29 patients with secondary cerebral infarction were enrolled into HI group and 84 patients without secondary cerebral infarction were selected as control group. The independent risk factors of secondary HI in patients with non-valvular atrial fibrillation were analyzed. Results The patients with diabetes mellitus, hypertension, cerebral embolism, cerebral infarction involving cortex and large area cerebral infarction in the HI group were more than those in the control group, the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that the diabetes mellitus, hypertension, the type, location and area of infarction were independent risk factors for secondary HI in patients with non-valvular atrial fibrillation (P<0.05). Conclusion Diabetes mellitus, hypertension history, cerebral embolism, cerebral infarction involving cortex and large area cerebral infarction can increase the risk of secondary HI in patients with non-valvular atrial fibrillation. In clinical practice, corresponding interventions can be formulated as early as possible according to whether patients have the above risk factors, so as to minimize the risk of secondary HI in patients with non-valvular atrial fibrillation, and to ensure the overall therapeutic effect of the disease and improve the prognosis of patients.