论文部分内容阅读
目的 探讨风湿性心脏病 (RHD)患者栓塞发生率及栓塞的危险因素。方法 统计了我院 14 6例RHD患者的栓塞发生率。发生栓塞者 34例及无栓塞者 112例 ,根据有无栓塞进行单因素分析 ,最后用Logistic回归分析RHD发生栓塞的危险因素。结果 自然病程 (未换瓣 )的RHD患者栓塞发生率为 2 5 .6 % ,伴心房纤颤 (Af)栓塞发生率是 30 .4 % ,窦性心律者栓塞发生率是 9.7%。栓塞组年龄、左房内径 ,伴发Af比例较无栓塞组高 (P <0 .0 1～0 .0 5 )。Logistic回归分析显示高龄、左房内径大是栓塞的独立危险因素 (P <0 .0 5 )。接受换瓣手术和抗凝治疗是栓塞的保护因素 (OR =0 .0 3)。结论 RHD患者应给予抗凝治疗。
Objective To investigate the incidence of embolism and the risk factors of embolism in patients with rheumatic heart disease (RHD). Methods The incidence of embolism in 14 6 RHD patients in our hospital was calculated. Thirty-four patients with embolism and 112 patients without embolism were analyzed by univariate analysis with or without embolization. Logistic regression was used to analyze the risk factors of embolism in RHD. Results The incidence of embolization was 25.6% in RHD patients with natural disease (non-valve flap), 30.4% in patients with atrial fibrillation (Af), and 9.7% in patients with sinus rhythm. Embolization group age, left atrial diameter, associated with the proportion of Af than no embolization group (P <0.01 ~ 0.05). Logistic regression analysis showed that older age and larger left atrium diameter were independent risk factors for embolism (P <0.05). Valve replacement surgery and anticoagulation were protective factors for embolization (OR = 0.30). Conclusion RHD patients should be given anticoagulant therapy.