摘要
目的 探讨慢性心力衰竭(chronic heart failure, CHF)合并缺血性脑卒中患者的临床特点及相关危险因素。方法 回顾性选取2021年1月至2023年1月江苏省苏北人民医院住院未合并心房颤动/心房扑动的老年CHF患者153例,根据诊断分为CHF组84例,缺血性脑卒中组69例(CHF+缺血性脑卒中)。收集所有患者一般资料、既往病史、辅助检查指标等临床数据。随访6个月,采用多因素logistic回归分析及ROC曲线分析缺血性脑卒中相关的危险因素。结果 2组年龄、高血压、糖尿病、部分凝血活酶时间、左心房内径、左心室射血分数、右心室内径、左心室收缩末期内径、左心室舒张末期内径、CHF分型、CHA_(2)DS_(2)-VASc评分、HAS-BLED评分、抗血小板药物比例比较,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,CHA_(2)DS_(2)-VASc评分(OR=2.471,95%CI:1.356~4.502,P=0.003)、HAS-BLED评分(OR=6.626,95%CI:2.049~21.432,P=0.002)是发生缺血性脑卒中的独立危险因素。ROC曲线分析显示,CHA_(2)DS_(2)-VASc评分预测无心房颤动/心房扑动的老年CHF患者发生缺血性脑卒中的曲线下面积为0.936(95%CI:0.898~0.975,P<0.01);HAS-BLED评分预测无心房颤动/心房扑动的老年CHF患者发生缺血性脑卒中的曲线下面积为0.922(95%CI:0.880~0.964,P<0.01)。结论 CHA_(2)DS_(2)-VASc评分和HAS-BLED评分高是无心房颤动/心房扑动的老年CHF患者发生缺血性脑卒中的独立危险因素。
Objective To investigate the elinical features and related risk factors of chronic heart failure(CHF)patients with ischemic stroke.Methods A total of 153 elderly CHF patients with-out atrial fibrillation(AF)/atrial flutter(AFL)admitted in our hospital from January 2021 to.January 2023 were enrolled,and according to diagnosis,they were divided into CHF group(84 cases)and ischemic stroke group(69 cases,CHF+ischemic stroke).General information,medical history and auxiliary examination indicators were collected.All of them were followed up for 6 months.SPSS statistical software was used to analyze the data of the 2 groups of patients.and the.risk factors related to ischemic stroke were identified.Results Significant differences were observed in terms of age,hypertension,diabetes,partial thromboplastin time,left atrial diameter,left ventricular ejection fraction,right ventricular dia meter,left ventricular end systolic diameter,left ventricular end:diastolic diameter,CHF classification,thrombosis risk(CHA_(2)DS_(2)-VASc)score,HAS BLED score,and usage of antiplatelet agents between the two groups(P<0.05,P<0.01).Multivariate logistic regression analysis showed that CHA_(2)DS_(2)-VASc score(OR=2.471,95%CI:1.356-4.502,P=0.003)and HAS BLED score(OR=6.626,95%CI:2.049-21.432,P=0.002)were independent risk factors for ischemic stroke.ROC curve analysis indicated that the AUC value of CHA2DS&-VASc score and HAS BLED score in predicting ischemic stroke in elderly CHF patients without AF/AFL was 0.936(95%CI:0.898-0.975,P<0.01)and 0.922(95%CI:0.880-0.964,P<0.01),respectively.Conclusion High CHA DS2-VASc score and high HAS BLED score are independent risk factors for ischemic stroke in elderly CHF patients with-out AF/AFL.
作者
张清洋
朱业
顾翔
Zhang Qingyang;Zhu Ye;Gu Xiang(Department of Cardiovascular Diseases,North Jiangsu People's Hospital,Yangzhou 225001,Jiangsu Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第9期1026-1030,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(81800250)
中国博士后科学基金(2022M711417)
江苏省中医药科技发展计划项目(MS2023137)
扬州市科技计划项目(YZ2023096)。
