中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2008年
8期
819-822
,共4页
脑卒中%心房颤动%危险因素
腦卒中%心房顫動%危險因素
뇌졸중%심방전동%위험인소
Stroke%Atrial fibrillation%Risk factor
目的 了解非瓣膜件心房颤动(房颤)患者缺血性脑卒中危险因素暴露水平及危险因素个体聚集情况,为制定房颤患者脑卒中预防策略提供依据.方法 2006年采用两阶段抽样方法 ,先从北京市城区选择8所三级医院和7所二级医院(社区卫生服务中心),再由内科医生对门诊随机抽取的非瓣膜性房颤患者采取统一问卷调查.结果 583例非瓣膜性房颤患者中缺血性脑卒中患者133例,患病率22.8%,其中78例发生在房颤诊断后,与房颤相关的缺血性脑卒中患病率为13.4%.年龄(χ2=17.040,P<0.001)、房颤病程(χ2=33.300,P<0.001)、高血压病(χ2=9.933,P=0.002)、糖尿病(χ2=8.038,P=0.005)、冠心病(χ2=5.046,P=0.025)、血脂异常(χ2=8.192,P=0.004)的暴露水平在脑卒中和非脑卒中患者间差异有统计学意义.多因素logistic回归分析显示:年龄、房颤病程、糖尿病、血脂异常增加脑卒中患病危险,OR值分别为1.06、2.08、1.82、1.79,95%CI不包含1.调整年龄、性别、房颤病程的影响后,具有3个和4个危险因素者脑卒中患病危险分别为没有危险因素的4.36倍和4.51倍.结论 年龄、房颤病程、糖尿病病史、血脂异常增加房颤患者脑卒中的患病危险,多个危险因素的聚集致脑卒中的患病危险进一步增加;房颤患者预防脑卒中发生除抗凝和抗血小板治疗外,还应有效控制血压、血糖和血脂.
目的 瞭解非瓣膜件心房顫動(房顫)患者缺血性腦卒中危險因素暴露水平及危險因素箇體聚集情況,為製定房顫患者腦卒中預防策略提供依據.方法 2006年採用兩階段抽樣方法 ,先從北京市城區選擇8所三級醫院和7所二級醫院(社區衛生服務中心),再由內科醫生對門診隨機抽取的非瓣膜性房顫患者採取統一問捲調查.結果 583例非瓣膜性房顫患者中缺血性腦卒中患者133例,患病率22.8%,其中78例髮生在房顫診斷後,與房顫相關的缺血性腦卒中患病率為13.4%.年齡(χ2=17.040,P<0.001)、房顫病程(χ2=33.300,P<0.001)、高血壓病(χ2=9.933,P=0.002)、糖尿病(χ2=8.038,P=0.005)、冠心病(χ2=5.046,P=0.025)、血脂異常(χ2=8.192,P=0.004)的暴露水平在腦卒中和非腦卒中患者間差異有統計學意義.多因素logistic迴歸分析顯示:年齡、房顫病程、糖尿病、血脂異常增加腦卒中患病危險,OR值分彆為1.06、2.08、1.82、1.79,95%CI不包含1.調整年齡、性彆、房顫病程的影響後,具有3箇和4箇危險因素者腦卒中患病危險分彆為沒有危險因素的4.36倍和4.51倍.結論 年齡、房顫病程、糖尿病病史、血脂異常增加房顫患者腦卒中的患病危險,多箇危險因素的聚集緻腦卒中的患病危險進一步增加;房顫患者預防腦卒中髮生除抗凝和抗血小闆治療外,還應有效控製血壓、血糖和血脂.
목적 료해비판막건심방전동(방전)환자결혈성뇌졸중위험인소폭로수평급위험인소개체취집정황,위제정방전환자뇌졸중예방책략제공의거.방법 2006년채용량계단추양방법 ,선종북경시성구선택8소삼급의원화7소이급의원(사구위생복무중심),재유내과의생대문진수궤추취적비판막성방전환자채취통일문권조사.결과 583례비판막성방전환자중결혈성뇌졸중환자133례,환병솔22.8%,기중78례발생재방전진단후,여방전상관적결혈성뇌졸중환병솔위13.4%.년령(χ2=17.040,P<0.001)、방전병정(χ2=33.300,P<0.001)、고혈압병(χ2=9.933,P=0.002)、당뇨병(χ2=8.038,P=0.005)、관심병(χ2=5.046,P=0.025)、혈지이상(χ2=8.192,P=0.004)적폭로수평재뇌졸중화비뇌졸중환자간차이유통계학의의.다인소logistic회귀분석현시:년령、방전병정、당뇨병、혈지이상증가뇌졸중환병위험,OR치분별위1.06、2.08、1.82、1.79,95%CI불포함1.조정년령、성별、방전병정적영향후,구유3개화4개위험인소자뇌졸중환병위험분별위몰유위험인소적4.36배화4.51배.결론 년령、방전병정、당뇨병병사、혈지이상증가방전환자뇌졸중적환병위험,다개위험인소적취집치뇌졸중적환병위험진일보증가;방전환자예방뇌졸중발생제항응화항혈소판치료외,환응유효공제혈압、혈당화혈지.
Objective To analyze the level of exposure and cluster of risk factors to stroke for patients with non valvular atrial fibrillation. Methods A questionnaire survey was conducted among 583 patients with non valvular atrial fibrillation, randomly selected from 8 general hospitals and 7 community health service centers located in the 8 districts in Beijing city in 2006. Results 133 patients attacked stroke and the prevalence of stroke in the total 583 patients was 22.8%. 78 patients attacked stroke after being diagnosed as atrial fibrillation with the prevalence related to atrial fibrillation as 14.3%. The levels of exposure related to age, duration of atrial fibrillation, histories of hypertension, diabetes and dyslipdemia were significantly different between stroke and non-stroke patients (P<0.05). Data from multiple variables logistic regression analysis showed that age, duration of atrial fibrillation, history of dyslipdemia and history of diabetes increased the risk of stroke with odds ratio as 1.06,2.08,1.82,1.79 respectively (95 % CI was not including 1 ). The risk of stroke among those having 3 or 4 risk factors was 4.36 and 4.51 times of those without risk factor after adjusting for age, sex and duration of atrial fibrillation.Conclusion Age, duration of atrial fibrillation, history of dyslipdemia and history of diabetes were the main risk factors related to stroke and the clustering of risk factors would further increase the risk. It is important to control blood pressure, blood surge and lipid besides therapy of and.coagulation or antiplatelet for parents with nonvalvular atrial fibrillation.
