摘要
目的:探讨住院心房颤动(房颤)患者血管性认知功能障碍(VCI)的发生率及相关危险因素。方法:选择兰州大学第二医院住院的房颤患者303例,根据简易智能状态检查量表(MMSE)评分分为无VCI组216例,VCI组87例。评估住院房颤患者VCI的发生率,并对VCI进行单因素及多因素分析。结果:与无VCI组比较,VCI组年龄较大,CHA2DS2-VASC评分≥2分、持续/永久性房颤、合并糖尿病及心力衰竭的比例、收缩压、平均动脉压、脉压,左心房前后径及血肌酐较高,男性比例及左心室舒张末内径较低,差异具有统计学意义(P<0.05或P<0.001)。住院房颤患者VCI发生率为40.3%,随着年龄的增大、CHA2DS2-VASC评分的增高,VCI发生率增加,女性VCI发生率高于男性,持续及永久性房颤患者VCI发生率高于阵发性房颤患者(P<0.05或P<0.001)。多元线性回归分析显示,年龄(OR=-0.1135,95%CI:-0.1708^-0.0562,P=0.0001)、女性(OR=-1.2528,95%CI:-2.2056^-0.3000,P=0.0105)、文化水平(小学OR=3.2193,95%CI:1.8446~4.5940,P<0.0001;初中及以上OR=5.9104,95%CI:4.6055~7.2154,P<0.0001)、心力衰竭(OR=-1.9357,95%CI:-3.5522^-0.3192,P=0.0196)、脑卒中(OR=-1.6349,95%CI:-2.7517^-0.5181,P=0.0044)及左心房前后径(OR=-0.1252,95%CI:-0.1962^-0.0541,P=0.0006)与住院房颤患者VCI发生相关。结论:住院房颤患者VCI发生率高,高龄、女性、较低文化水平、心力衰竭、脑卒中及左心房前后径扩大是房颤患者发生VCI的相关危险因素。
Objective： To explore the incidence and risk factors of vascular cognitive impairment （VCI） for in-hospital atrial fibrillation （AF） patients. Methods： A total of 303 in-hospital AF patients were studied. Based on MMSE score evaluation, the patients were divided into 2 groups： Non-VCI group, n=216 and VCI group, n=87. The incidence of VCI was assessed and different cognitive functions were studied by uni- and multivariate regression analysis. Results： Compared with Non-VCI group, the patients in VCI group had the elder age, higher proportion of CHA2DS2-VASC score ≥ 2, more with persistent/permanent AF, more combining diabetes and heart failure （HF）, more had increased systolic blood pressure, mean arterial pressure, pulse pressure, left atrial （LA） diameter and serum creatinine; less male and decreased left ventricular end-diastolic diameter, P〈0.05 and P〈0.001. The occurrence rate of VCI for in-hospital patients was 40.3%, with age and CHA2DS2-VASC score increasing, the incidence of VCI was elevating and the occurrence rates in female was higher than male, the patients with persistent/permanent AF was higher than paroxysmal AF, P〈0.05 and P〈0.001. Multiple linear regression analysis showed that age （OR=-0.1135, 95% CI -0.1708 to -0.0562, P=0.0001）, female （OR=-1.2528, 95% CI -2.2056 to -0.3000, P=0.0105）, education [primary school level （OR=3.2193, 95% CI 1.844-4.5940, P〈0.0001）,middle school and above level （OR=5.9104, 95% CI 4.6055-7.2154, P〈0.0001）], HF （OR=-1.9357, 95% CI -3.5522 to-0.3192, P=0.0196）, stroke （OR=-1.6349, 95% CI -2.7517 to -0.5181, P=0.0044） and LA diameter （OR=-0.1252, 95% CI-0.1962 to -0.0541, P=0.0006） were related to VCI occurrence in hospitalized AF patients. Conclusion： The incidence of VCI was high in hospitalized AF patients; elder age, female, lower education, HF, stroke and enlarged LA diameter were the risk factors for VCI occurrence in AF patients.
作者
许广莉
高秉仁
林欣
王琼英
吴强
孙守刚
姜程
白锋
XU Guang-li GAO Bing-ren LIN Xin WANG Qiong-ying WU Qiang SUN Shou-gang JIANG Cheng BAI Feng(Department of Cardiology, Second Hospital of Lanzhou University, Lanzhou （730030）, Gansu, Chin)
出处
《中国循环杂志》
CSCD
北大核心
2017年第10期994-998,共5页
Chinese Circulation Journal
关键词
心房颤动
认知障碍
危险因素
Atrial fibrillation
Cognition Disorders
Risk factors
