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静息心率对缺血性脑卒中患者预后的影响

         

摘要

Objective To study the effect of resting heart rate on prognosis of patients with ischemic stroke. Methods From March 2013 to March 2014, 101 patients with infarction in Chinese Medicine Hospital of Luhe District were selected. All patients were kept under follow-up observation for 24 months. Among these patients who had been previously diag-nosed of cerebral infarction, 58 cases had been confirmed of developing new acute infarct by CT and/or MRI (acute symptom group);43 cases did not develop new infarct according to CT and/or MRI, but only had been admitted into the hospital due to dizziness, limb weakness or discomfort (sequela group). The effect of resting heart rate on the prognosis of patients with ischemic stroke in two groups in acute stage and sequela stage was compared. Results At the sequela stage of cerebral infarction, both resting heart rate level and smoking rate in relapse group and the non-recurrence group were statistically significance (P<0.05 or P< 0.01), while the difference of age, sex, incidence of hypertension, diabetes incidence, FIB, hs-CRP, TC, TG, HDL-C, LDL-C, Essen value and BMI had no statistical significance (P>0.05). At the acute stage of cerebral infarction, both Essen value and hs-CRP in recurrence group and the non-recur-rence group had statistically significant difference (P< 0.01), while the difference of age, sex, incidence of hyperten-sion, diabetes incidence, smoking rate, resting heart rate, FIB, TC, TG, HDL-C, LDL-C, and BMI had no statistical sig-nificance (P>0.05). Logistic regression analysis showed that: resting heart rate was an important factor which causing recurrence of cerebral infarction (OR = 1.241; 95%CI = 1.074-1.434, P= 0.003). Conclusion The increasing resting heart rate is a risk factor for prognosis of ischemic stroke at the sequela stage.%目的:研究静息心率对缺血性脑卒中预后的影响。方法选取2013年3月~2014年3月南京市六合区中医院内科住院的脑梗死患者101例,所有患者均进行为期24个月的随访观察。其中初次或已经发生脑梗死患者经头颅CT和/或MRI证实有新的梗死灶的急性期组58例;发生过脑梗死患者再次因头昏、肢体乏力等不适入院,经头颅CT和/或MRI证实无新发脑梗死病灶的后遗症期组43例。比较静息心率对两组缺血性脑卒中患者急性期和后遗症期预后的影响。结果后遗症期中复发组和未复发组的静息心率水平及吸烟率比较,差异均有统计学意义(P<0.05或P<0.01);两组年龄、性别、高血压发病率、糖尿病发病率、纤维蛋白原(FIB)、超敏C反应蛋白(hs-CRP)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、Essen评分和体重指数(BMI)比较,差异均无统计学意义(P>0.05)。急性期中复发组和未复发组Essen评分和hs-CRP水平比较,差异均有高度统计学意义(P<0.01),两组年龄、性别、高血压发病率、糖尿病发病率、吸烟率、静息心率、FIB、TC、TG、HDL-C、LDL-C和BMI比较,差异无统计学意义(P>0.05);Logistic回归分析:静息心率水平是后遗症期脑梗死患者复发的重要因素(OR =1.241;95%CI=1.074~1.434,P=0.003)。结论静息心率增快是后遗症期缺血性脑卒中预后的危险因素。

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