非瓣膜病性心房颤伴缺血性卒中生存与复发因素分析

目的探讨非瓣膜病性房颤伴缺血性卒中患者的生存及复发影响因素。方法回顾性分析1992年～2002年在我院住院的非瓣膜病性房颤伴缺血性卒中患者386例,随访收集患者的有关临床资料,对患者进行生存分析,并研究其复发的有关因素。结果非瓣膜病性房颤伴缺血性卒中患者的10年累计死亡率为51%,复发率为34%,Cox回归单因素发现,高血压,糖尿病,短暂性脑缺血作(TIA),高脂血症,附壁血栓是非瓣膜病性房颤伴缺血性卒中患者复发的危险因素;而阿斯匹林治疗,华法令治疗与血压控制对复发有保护作用。Cox回归多因素分析发现高血压病、TIA发作史与附壁血栓为非瓣膜病性房颤合并缺血性卒中复发的独立危险因素;而阿斯匹林与华法令治疗对非瓣膜病性房颤合并缺血性卒中复发有保护作用。结论高血压病、TIA发作史与附壁血栓为非瓣膜病性房颤合并缺血性卒中复发的独立危险因素;而阿斯匹林与华法令治疗对非瓣膜病性房颤合并缺血性卒中复发有保护作用。

Survival Study of Ischemic Stroke in Nonvalvular Atrial Fibrillation and Related Recurrence Factors

Objective To study the survival of ischemic srtoke in patient with nonvalvular artial with NVAF. Methods From January, 1992 to February, 2002, the clinical data'of 386 patients with ischemic stroke in patient with NVAF in our hospital was included in this study. Basic clinical information of each patient was recorded. Survival analysis and related recurrence factors of ischemic stroke in patients with NVAF were conducted. Results Overall 10-year survival rate of ischemic stroke in patients with NVAF was 51%, recurrence rate was 34%. hypertension, diabetes mellitus, transient ischemic attack (TIA), hyperlipemia and mural thrombus in left atrium were significantly correlated with recurrence rate by univariate Cox proportional hazards regression analysis of ischemic stroke in patients with NVAF;but aspirin therapy,warfarin therapy and hypertension control were protective factors for recurrence of ischemic stroke in patients with NVAF.Multivariate Cox proportional hazards regression analysis revealed that hypertension, TIAand mural thrombus in left atrium were independent recurrence factors for ischemic stroke in patients with NVAF;but aspirin therapy and warfarin therapy were protective factors for recurrehce of ischemic stroke in patients with NVAF. Conclusion Hypertension, TIA and mural thrombus in left atrium were independent recurrence factors for ischemic stroke in patients with NVAF;but aspirin therapy and warfarin therapy were protective factors for recurrence of ischemic stroke in patients with NVAF.