左心房内径大小与缺血性脑卒中的相关性研究

CORRELATION BETWEEN THE SIZE OF LEFT ATRIAL DIAMETER AND ISCHEMIC STROKE IN PATIENTS

目的探讨左心房内径大小与缺血性脑卒中的相关性。方法回顾性纳入2017年10月到2018年9月在井冈山大学附属医院心血管内科、神经内科住院患者850例,分为非脑卒中组510例和缺血性脑卒中340例,比较两组患者的基线资料,并采用单因素与多因素Logistic回归分析缺血性脑卒中的危险因素,然后采用Spearman相关分析左心房内径大小与缺血性脑卒中的相关性。结果两组患者性别、年龄、酗酒史、肌酐、D2聚体、ALP差异均无统计学意义(P>0.05),而吸烟史、高血压、糖尿病、颈动脉斑块、TG、CHOL、LDL-C、HCY差异均有统计学意义(P>0.05),缺血性脑卒中组左心房内径为(38.12±3.8),明显大于非脑卒中组(31.43±2.86)mm,差异有统计学意义(P>0.01)。单因素Logistic回归分析显示,吸烟史、高血压、糖尿病、颈动脉斑块、左心房内径大小、血脂异常、HCY是缺血性脑卒中的危险因素(P<0.05)。校正了吸烟史、高血压、糖尿病、颈动脉斑块、血脂异常等危险因素后,多因素Logistic回归分析显示,左心房内径大小仍是缺血性脑卒中的危险因素。Spearman相关分析显示,左心房内径大小与缺血性脑卒中呈正相关(r=0.618,P=0.000)。结论左心房扩大是缺血性脑卒中的危险因素,与性别无关。

Objective: To investigate the relationship between the size of left atrial diameter and ischemic stroke in patients. Methods: A retrospective study of 850 inpatients from October 2017 to September 2018 in the Department of Cardiovascular Medicine and Neurology of the Affiliated Hospital of Jinggangshan University was conducted. They were divided into 510 non-stroke patients and 340 ischemic stroke patients. The baseline data of the two groups were compared and the risk factors of ischemic stroke were analyzed by single-factor and multi-factor logistic regression,Then Spearman correlation was used to analyze the correlation between left atrial diameter and ischemic stroke. Results: There were no significant differences in sex, age, history of alcohol abuse, creatinine, D2 polymer and ALP between the two groups(P > 0.05), but there were significant differences in smoking history, hypertension, diabetes, carotid plaque, TG, CHOL, LDL-C and HCY(P < 0.05).The diameter of left atrium in ischemic stroke group was 38.12± 3.8, which was significantly larger than that in non-stroke group(31.43 ± 2.86)(P < 0.01). Univariate logistic regression analysis showed that smoking history,hypertension, diabetes mellitus, carotid plaque, left atrial diameter, dyslipidemia and HCY were risk factors for ischemic stroke(P < 0.05). After adjusting for smoking history, hypertension, diabetes, carotid plaque, dyslipidemia and other risk factors, multivariate logistic regression analysis showed that left atrial diameter was still a risk factor for ischemic stroke. Spearman correlation analysis showed that left atrial diameter was positively correlated with ischemic stroke(r = 0.618, P = 0.000). Conclusion: Left atrial enlargement in patients is a risk factor for ischemic stroke, not related to gender.