摘要
目的 探讨老年卵圆孔未闭患者发生隐源性脑卒中的危险因素.方法 选取2019年1月至2023年12月上饶市人民医院收治的80例卵圆孔未闭老年患者作为研究对象,其中未伴有隐源性脑卒中的40例患者为对照组,伴有隐源性脑卒中的40例患者为观察组,采用单因素分析与多因素logistic回归分析老年卵圆孔未闭患者发生隐源性脑卒中的影响因素.结果 单因素分析结果显示,两组的年龄、性别、体重指数、缺血性心脏病、既往脑卒中发作史、饮酒、药物使用情况、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖值、合并房间隔瘤、合并高活动度房间隔、合并过长的下腔静脉瓣、合并希阿里氏网、大量右向左分流情况比较,差异无统计学意义(P＞0.05);而两组的血管危险因素(高血压、高脂血症、糖尿病、偏头痛、吸烟)、血压水平(舒张压、收缩压)、高半胱氨酸水平、卵圆孔未闭影像学特征(长度、宽度、静息右向左分流)比较,差异有统计学意义(P＜0.05).多因素logistic回归分析结果显示,舒张压升高(β=1.471,OR=4.35,95％CI:2.348～8.072)、卵圆孔未闭长度增加(β=1.744,OR=5.72,95％CI:2.429～13.471)、静息右向左分流(β=1.415,OR=4.12,95％CI:1.678～10.102)是老年卵圆孔未闭患者发生隐源性脑卒中的独立危险因素(P＜0.05).结论 舒张压升高、卵圆孔未闭长度增加、静息右向左分流是上饶地区老年卵圆孔未闭患者发生隐源性脑卒中的独立危险因素,可通过这些特征对老年卵圆孔未闭患者是否有隐源性脑卒中的发生风险进行识别.
Abstract
Objective To explore the risk factors of cryptogenic stroke in elderly patients with patent foramen ovale.Methods A total of 80 elderly patients with patent foramen ovale admitted to ShangRao People's Hospital from January 2019 to December 2023 were selected as the study objects,including 40 patients without cryptogenic stroke as the control group and 40 patients with cryptogenic stroke as the observation group.Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of cryptogenic stroke in elderly patients with patent foramen ovale.Results Univariate analysis showed that,there were no significant differences in age,sex,body mass index,ischemic heart disease,previous stroke history,alcohol consumption,drug use,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,fasting blood glucose value,combined atrial septal tumor,combined with high activity atrial septa,combined with long inferior vena cava valve,combined with Chiari network,and numerous right-to-left shunt between the two groups(P＞0.05).While the primary disease(hypertension,hyperlipidemia,diabetes,migraine,smoking),blood pressure(diastolic blood pressure,systolic blood pressure),homocysteine level,and imaging characteristics of patent foramen ovalis(length,width,and resting right-to-left shunt)were statistically significant between the two groups(P＜0.05).Multiariable logistic regression analysis results showed that diastolic blood pressure increased(β=1.471,OR=4.35,95％CI:2.348-8.072),length of patent foramen ovale increased(β=1.744,OR=5.72,95％CI:2.429-13.471),and resting right-to-left shunt(β=1.415,OR=4.12,95％CI:1.678-10.102)was independent risk factors of cryptogenic stroke in elderly patients with patent foramen ovale(P＜0.05).Conclusion Diastolic blood pressure increased,length of patent foramen ovale increased,and resting right-to-left shunt are independent risk factors of cryptogenic stroke in elderly patients with patent foramen ovale.These characteristics can be used to identify the risk of cryptogenic stroke in elderly patients with patent foramen ovale.
基金项目
江西省卫生健康委科技计划项目(202312288)
维普
万方数据