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目的:调查铜川市老年非瓣膜病心房颤动(nonvalvular atrial fibrillation,NVAF)患者脑栓塞(cerebral embol-ism,CE)的危险因素。方法:铜川地区非瓣膜病心房纤颤发生脑卒中确诊病例309例,进行1∶1配对进行病例对照研究,获得环境暴露等资料,采用EPI-info(6.04)和SPSS(15.0)统计软件进行单因素和多因素Logistic回归分析,计算各因素的调整比值比(OR)和95%可信限(CI)。结果:单因素分析发现,老年NVAF患者并发高血压病、糖尿病、心力衰竭、短暂性脑缺血发作(TIA)、肥胖、吸烟、酗酒、高同型半胱氨酸血症等与CE成正相关,而抗凝治疗能降低患CE的危险。多因素分析结果显示,高血压病、糖尿病、TIA、高同型半胱氨酸血症是CE的独立危险因素。结论:铜川市NVAF患者发生CE的独立危险因素是高血压病、糖尿病、TIA和高同型半胱氨酸血症,抗凝治疗是其保护因素。
Objective: To investigate the risk factors of cerebral embolism (CE) in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods: A total of 309 confirmed stroke patients with atrial fibrillation of non-valvular disease in Tongchuan were enrolled in this study. A case-control study was conducted with a 1: 1 pair to obtain environmental exposure data. EPI-info (6.04) and SPSS Factors and multivariate Logistic regression analysis were used to calculate adjusted odds ratio (OR) and 95% confidence (CI) for each factor. Results: Univariate analysis found that elderly NVAF patients with hypertension, diabetes, heart failure, transient ischemic attack (TIA), obesity, smoking, alcoholism, hyperhomocysteinemia and CE were positively correlated, Anticoagulant therapy can reduce the risk of developing CE. Multivariate analysis showed that hypertension, diabetes, TIA, hyperhomocysteinemia were independent risk factors for CE. Conclusion: The independent risk factors of CE in patients with NVAF in Tongchuan are hypertension, diabetes, TIA and hyperhomocysteinemia. Anticoagulant therapy is the protective factor.