摘要
目的 探讨急性心肌梗死 (心梗 )住院患者脑卒中发病率和脑卒中的危险因素。方法 回顾性调查住院心梗患者 ,收集人口、临床、溶栓抗栓治疗和脑卒中发病资料 ,应用单因素和多因素非条件logistic回归分析。 结果 2 133例急性心梗住院患者脑卒中的发病率为 4 .5 9%。多因素非条件逐步logistic回归分析显示 ,前壁心梗是急性心梗患者发生脑卒中最强的危险因素 (RR =7.0 4 ) ,其余的依次为高血压病史 (RR =3.4 1)、心房纤颤 (RR =2 .2 2 )、脑卒中病史 (RR =1.6 9)、高龄(RR =1.0 4 )和入院时心率 (RR =1.0 3) ,溶栓治疗是保护性因素 (RR =0 .12 )。结论 急性心梗住院患者脑卒中发病率较高 ,溶栓剂可减低脑卒中发病率 ,高龄、高血压病史、脑卒中史、心房纤颤、入院时心率增快和前壁心梗是急性心梗患者脑卒中的危险因素。
Objective To determine the incidence and risk factors for in hospital stroke in patients with acute myocardial infarction(AMI). Methods Two thousand one hundred and thirty three patients with acute myocardial infarction were studied retrospectively. History,demographic,clinical, thrombolytic and anticoagulant data of AMI were obtained through review of the medical record. The relative risk of in hospital stroke in patients with AMI was estimated using multiple nonconditional logistic regression to adjust for potential confounding factors. Results Among 2 133 consecutive patients admitted with acute myocardial infarction to hospitals in Shandong and Hubei provinces, 98( 4.59 %) experienced strokes during hospitalization. In our analysis,anterior infarction was the most important risk factor for in hospital stroke (ischemic and hemorrhagic) in patients with AMI ( RR = 7.04 ), followed by history of hypertention ( RR = 3.41 ), previous stroke ( RR = 1.69 ), atrial fibrillation ( RR = 2.22 ), advanced age ( RR = 1.04 ), and higher heart rate at enrollment ( RR = 1.03 ). Conclusions The incidence of in hospital stroke in patients with AMI increased with lower rate of using thrombolytic agents. Thrombolytic therapy was noticed as a protective factor for stroke after AMI. The risk factors for in hospital stroke with AMI were history of hypertention, previous stroke, atrial fibrillation, advanced age, anterior infarction, and higher heart rate at enrollment.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2002年第6期457-460,共4页
Chinese Journal of Epidemiology
