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目的探讨左房内径及其各参数对原发性高血压(EH)患者发生缺血性脑卒中(IS)的预测作用,为EH患者脑卒中的防治提供依据。方法收集住院EH患者950例,分为EH非IS组与EH+IS组,采用多因素分析方法探讨EH患者IS发生与左房内径等因素的相关性,比较左房内径各参数对IS的预测作用。结果共收入EH无脑卒中并发症患者624名,EH+IS组326名。通过logistic条件逐步回归分析,发现EH患者发生IS的独立危险因素为糖尿病(OR=1.701,P=0.027),血清总胆固醇(TC,OR=1.415,P=0.001),血清纤维蛋白原(Fg,OR=1.172,P=0.05),左室后壁厚度(PWT,OR=1.312,P=0.001),左房内径(LAD,OR=1.398,P=0.001),二尖瓣口舒张早期和舒张晚期流速峰值比值(E/A)(OR=0.024,P=0.001)。排除其他影响因素[如年龄、性别、体质量指数(BMI)、吸烟、饮酒史、糖尿病、TC、Fg、PWT]后,左房内径仍与IS相关(OR=1.209)。不同左房参数在EH病人发生IS的危险评估依次为LAD/体表面积(OR=1.291)>LAD/身高(OR=1.274)>LAD(OR=1.209)。结论左房内径能独立预测EH患者发生IS的危险。
Objective To investigate the predictive value of left atrium diameter and its parameters on ischemic stroke (IS) in patients with essential hypertension (EH), and to provide evidence for the prevention and treatment of stroke in EH patients. Methods A total of 950 inpatients with EH were enrolled and divided into two groups: EH non-IS group and EH + IS group. Multivariate analysis was used to investigate the correlation between IS occurrence and left atrium diameter in EH patients. effect. Results A total of 624 EH stroke-free complication patients and 326 EH + IS patients were included. By stepwise logistic regression analysis, it was found that the independent risk factors of IS in patients with EH were diabetes (OR = 1.701, P = 0.027), serum total cholesterol (TC, OR = 1.415, P = 0.001), serum fibrinogen OR = 1.172, P = 0.05), left ventricular posterior wall thickness (PWT, OR = 1.312, P = 0.001), left atrium diameter (LAD, OR = 1.398, P = 0.001), mitral early diastole and late diastole Peak flow velocity ratio (E / A) (OR = 0.024, P = 0.001). Left atrial diameter was still related to IS (OR = 1.209) after excluding other influencing factors [such as age, sex, body mass index (BMI), smoking, alcohol history, diabetes, TC, Fg, PWT). The risk assessment of IS with different left atrial parameters in patients with EH followed by LAD / body surface area (OR = 1.291)> LAD / height (OR = 1.274)> LAD (OR = 1.209). Conclusion Left atrial diameter can independently predict the risk of IS in EH patients.