非瓣膜性心房颤动脑栓塞患者脑微出血危险因素的Logistic回归分析

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摘要目的分析非瓣膜性心房颤动脑栓塞患者脑微出血（CMB）发生的危险因素，为此类患者治疗方案提供指导。方法选取2014年1月～2016年12月在苏州大学附属太仓医院神经内科住院合并非瓣膜性心房颤动脑栓塞患者117例，根据有无CMB分为CMB组（48例）和非CMB组（69例），比较两组患者的人口学特征、常见卒中危险因素、实验室检查指标。结果入选的117例患者中，48例（41%）被检测出合并CMB，CMB组患者平均年龄大于非CMB组（P = 0.002），同型半胱氨酸（Hcy）水平高于非CMB组（P = 0.033），CMB组患者低密度脂蛋白（LDL-C）水平低于非CMB组（P = 0.037），差异均有统计学意义。对可能的危险因素进行多因素Logistic回归分析显示高龄是CMB发生重要危险因素（P = 0.07，OR = 1.079，95%CI：1.021~1.140）。结论合并非瓣膜性心房颤动脑栓塞患者CMB发生率较高，患者CMB的发生主要与患者高龄相关。

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	吴毅杰1 沈佳慧1 周亦2 赵合庆3 周立辉1▲

关键词 ：心房颤动, 脑栓塞, 脑微出血

Abstract：Objective To analyze the cerebral microbleeds (CMB) risk factors of patients with non-valvular atrial fibrillation and cerebral infarction, and provide guidance for therapeutic schedule for these patients. Methods One hundred and seventeen patients with non-valvular atrial fibrillation and cerebral infarction were enrolled that treated in the Department of Neurology, the Taicang Affiliated Hospital of Soochow University from January 2014 to December 2016, that were divided into CMB group (48 cases) and non-CMB group (69 cases). The demographic characteristics, the common risk factors of stroke and laboratory examination indices were compared between the two groups. Results Among the 117 patients, 48 cases (41%) were detected with CMB; the average age of the CMB group was higher than the non-CMB group (P = 0.002) ; the homocyatein (Hcy) level of the CMB group was higher than the non-CMB group (P = 0.033) ; the low density lipoprotein (LDL-C) of the CMB group was lower than the non-CMB group (P = 0.037); all the differences were statistically significant. Through a Logistic regression analysis, elderly was independently associated with the presence of CMB (P = 0.07, OR = 1.079, 95%CI: 1.021-1.140). Conclusion There is a high prevalence of CMB in patients with non-valvular atrial fibrillation and cerebral infarction and the occurrence of CMB is mainly associated with elderly.

Key words： Atrial fibrillation Cerebral microbleeds Cerebral microbleeds

基金资助:江苏省苏州市科技发展计划（应用基础研究-医疗卫生）项目（SYSD2015097）。

通讯作者: ▲通讯作者

作者简介: 吴毅杰（1987.2-），男，硕士，主要从事脑血管病的研究。

引用本文:

吴毅杰1 沈佳慧1 周亦2 赵合庆3 周立辉1▲. 非瓣膜性心房颤动脑栓塞患者脑微出血危险因素的Logistic回归分析[J]. 中国医药导报, 2018, 15(20): 54-57.
WU Yijie1 SHEN Jiahui1 ZHOU Yi2 ZHAO Heqing3 ZHOU Lihui1▲. Logistic regression analysis of cerebral microbleeds risk factors of patients with non-valvular atrial fibrillation and cerebral infarction. 中国医药导报, 2018, 15(20): 54-57.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I20/54

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