老年房颤和脑梗塞

A pathogenic analysis of atrial fibrillation and the relationship between atrial fibrillation and cerebral infarction in aged patients

  • 摘要: 目的: 了解老年房颤患者房颤的原因,探讨房颤和脑梗塞发生的关系,以及抗凝治疗在预防房颤患者脑梗塞发生的作用。方法: 记录房颤患者的病因、超声心动图心脏附壁血栓发现率、LVEF、抗凝治疗及脑梗塞发生情况,同时记录心脏病无房颤患者及非心脏病无房颤患者脑梗塞发生情况。结果: 102例房颤患者中,病因以冠心病(59.8%)、高心病(10.8%)、心肌病(包括扩张性和肥厚性心肌病6.9%)为常见;超声心动图检查,于左心房发现附壁血栓3例;房颤组脑梗塞发生率为33.3%,心脏病无房颤组脑梗塞发生率为14.6%,而非心脏病无房颤组脑梗塞发生率为4.0%,P<0.01;房颤与心脏病无房颤患者LVEF值分别为48.9%±5.8和49.3%±4.7,P>0.05;阵发房颤与持续房颤患者脑梗塞发生率分别为22.4%和43.4%,P<0.01;持续房颤发生时间1年以内者脑梗塞发生率为25.0%,13年者为45.8%,3年以上者为52.9%,P<0.05;持续性房颤患者中未用或偶尔使用抗凝剂者和长期使用者脑梗塞发生率分别为52.4%和37.5%,P<0.05。结论: 房颤是老年人脑梗塞发生的危险因素之一,抗凝治疗能够降低这种危险。

     

    Abstract: Objective: In order to know the pathogeny of atrial fibrillation,to discuss the relationship between artial fibrillation and cerebral infarction,and the effect of anti congulation treatment in preventing the generation of cerebal infarction in artial fibrillation patients Methods: Make a record of the pathogeny-discovering rate of heart thrombosis in echocardiography-LEVF-anti congulatin treatment and the generation of cerebal infarction At the same time,make a record of the happening situation of cerebal infarction between the patients with heart disease who have no artial fibrillation and patients without heart disease and artial fibrillation Results: Among 102 cases with artial fibrillation,the common pathogeny is coronary heart disease(59 8%)-hypertensive heart disease(10.8%) cardomyopathy (including congestive and hypertrophic cardomyopathy 6 9%);the examination of echocardiograpgy shows,3 cases were discovered thombosis in left atrial;the rate of cerebal infarction is 33 3% in artial fibrillation group,the rate of cerebal infarction is 14 6% in heart disease without artial fibrillation group,otherwise,the rate of cerebal infarction is 4 0% in the group with no heart disease no artial fibrillation,P<0.001;the value of LVEF is 48. 9% 5 8 and 49. 3% 4 7,P > 0.05 respectively in artial fibrillation and heart disease without artial fibrillation group;the rate of cerebal infarction is 22 4% and 43. 4%P<0.001 respectively in transient artial fibrillation and continuous artial fibrillation;in continuous artial fibrillation group,the rate of cerebal infarction is elevated as well as time goes on,the period shorter than 1 year,the rate is 25 0%,1~3 year the rate is 45 8%,longer than 3 year the rate is 52. 9%,P<0.005;the rate of cerebal infarction is 52. 4% and 37. 5%,P<0.005respectively in patients with continuous artial fibrillation who never or occasionally use anti congulation treatment and long term use anti congulation treatment Results: Artial fibrillation is one of dangerous reasons in the happening of cerebal infarction,and anti congulation treatment can reduce this kind of danger

     

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