Zhongguo cuzhong zazhi (Jun 2019)

西安地区伴心房颤动老年急性缺血性卒中患者临床特征及1年预后分析 Clinical Characteristics and 1-Year Prognosis in Elderly Acute Ischemic Stroke Patients with Atrial Fibrillation in Xi'an Area

  • 刘仲仲，蔺雪梅，段康丽，逯青丽，曹欢，王静，王芳，史亚玲，王清，吴松笛

DOI
https://doi.org/10.3969/j.issn.1673-5765.2019.06.011
Journal volume & issue
Vol. 14, no. 6
pp. 578 – 584

Abstract

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【摘要】 目的 探讨西安地区伴心房颤动老年急性缺血性卒中（acute ischemic stroke，AIS）患者临床特征及1 年预后情况。 方法 通过西安卒中数据库平台，收集西安市4所三级甲等医院2015年1-12月连续入院的老年AIS （年龄≥65岁）患者的临床资料，比较分析伴心房颤动老年AIS患者的临床特征；登记随访1年的结局 事件（包括卒中复发、死亡和预后不良），通过多因素Logistic回归分析，探讨西安地区伴心房颤动老 年AIS患者1年不良预后的独立危险因素。 结果 研究最终纳入老年AIS患者1239例，其中伴心房颤动者133例（10.7%）。与不伴心房颤动组相比， 伴心房颤动老年AIS患者的年龄大[（77.7±6.3）岁 vs（74.0±6.1）岁，P=0.019]、出院mRS评分高（2.0 分 vs 1.0分，P0.05）。 结论 相比不伴心房颤动组，西安地区伴心房颤动老年AIS患者年龄更大、卒中所致残障及神经功 能缺损更重、合并肺炎和入院48 h不能行走的患者比例较高；伴心房颤动老年AIS患者1年死亡风险显 著升高。 【Abstract】 Objective To investigate the clinical characteristics and 1-year prognosis of elderly acute ischemic stroke (AIS) patients with atrial fibrillation (AF) in Xi'an area. Methods Clinical data of elderly patients with AIS (≥65 years) who were consecutively admitted to four tertiary-grade A class hospitals from January 2015 to December 2015 in Xi'an Stroke Data Bank were collected. The clinical characteristics of elderly AIS patients with and without AF were compared, and the outcome events of 1 year follow-up (including stroke recurrence, death and poor prognosis) were analyzed. Multivariate logistic regression analysis was used to find the independent risk factors for poor prognosis of 1 year in elderly AIS patients with AF in Xi'an area.Results Total 1239 elderly AIS patients were enrolled in this study, including 133 (10.7%) patients with AF. Comparing with the non-AF group, the elderly AIS patients in AF group showed older [(77.7±6.3) years vs (74.0±6.1) years, P=0.019], higher mRS score at discharge (median 2.0 vs 1.0, P0.05). Conclusions Comparing with the elderly AIS patients without AF, the elderly AIS patients with AF in Xi'an area were older, had more severe stroke, higher rate of pneumonia and higher rate of losing the ability to walk within 48h at admission, and higher risk of death at 1 year.

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