干旱区生态环境知识资源中心(Arid): 非ST段抬高急性冠状动脉综合征患者脑卒中事件

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	非ST段抬高急性冠状动脉综合征患者脑卒中事件
其他题名	Stroke Events in Patients with Non-ST Elevation Acute Coronary Syndromes in China
	王曼 1; 朱俊 1; 谭慧琼 1; 梁岩 1; 章晏 1; 刘力生 2
ISSN	1673-7245
出版年	2007
卷号	15 期号:10 页码:853-858
中文摘要	目的研究分析组织评估缺血综合征策略登记试验中国地区入选的非ST段抬高急性冠状动脉综合征患者,2年随访时脑卒中发生的特点以及与多种因素的关系.方法总结、分析所有入选患者自入院至2年随访时脑卒中事件的发生情况,对脑卒中和非脑卒中患者的特点进行比较,并采用生存分析(Cox回归)模型,分析就诊时一般情况、既往病史、住院与随访期间治疗等70余种因素对脑卒中发生的作用.结果中国地区共登记注册2294例患者,2年随访结束时共有93例(4.2%)发生105例次脑卒中事件,80%为缺血性脑卒中.脑卒中组年龄(67.69.6)岁,高于非脑卒中组(62.610.4)岁,差值5.0岁(P＜0.01,95%CI:2.837～7.138);入院时平均收缩压脑卒中组(147.425.2)mm Hg,高于非脑卒中组138.124.2 mm Hg,差值为9.3 mm Hg(P＜0.01,95%CI:4.276～14.346).脑卒中组既往脑卒中史、高血压史患者比例高于非脑卒中组(P＜0.01).脑卒中组总病死率明显高于非脑卒中组(P＜0.01).Cox回归分析显示既往脑卒中史(RR=2.329,95%CI:1.343～4.041),就诊时胸痛持续存在(RR=1.957,95%CI:1.261～3.037),既往高血压史(RR=1.848,95% CI:1.53～2.963),出院后随访期间非心血管疾病住院次数(RR=1.823,95%CI:1.122～2.960),年龄(RR=1.056,95%CI:1.031～1.081)是脑卒中的危险因素.入院前服用硝酸酯类药物(RR=0.537,95%CI:0.346～0.834),随访期间应用硝酸酯类药物频数(RR=0.803,95%CI:0.665～0.969)对脑卒中有保护作用.结论非ST段抬高急性冠状动脉综合征患者发生脑卒中事件者病死率进一步增加,主要为缺血性脑卒中.既往脑卒中病史、就诊时胸痛仍持续、既往高血压病史、年龄等因素使脑卒中发生的相对危险度增加;入院前、出院后随访期间应用硝酸酯类药物使脑卒中的相对危险度降低.
英文摘要	Objective To analyze the characteristics of stroke events in patients with non-ST elevation acute coronary syndromes during two years of follow-up in China and the relationship between stroke events and multiple risk factors. Methods This study was a part of an international multicenter registry organization to assess strategies for ischemic syndromes (OASIS). All patients had been followed up for two years. The patients’ clinical characteristics, therapeutic and major events during hospitalization and two years’ follow up period were compared between stroke and non-stroke patients. Cox regression model was used to analyze the association between stroke and multiple factors recorded, including baseline characteristics, previous medical history and therapeutic. Results Among the registered 2294 NSTE-ACS patients in China, 93(4.2%) had stroke events during 2 years follow up period, of which 80% were ischemic stroke. Mean age of stroke patients was 67.69.6 years higher than 62.610.4 years in patients without stroke(P<0.01,95% CI:2.837-7.138). Mean systolic blood pressure was 147.425.2 mm Hg in stroke patients, also higher than 138.124.2 mm Hg in patients without stroke(P<0.01, 95% CI:4.276-14.346). Previous history of stroke and hypertension were more common in patients with stroke(P<0.01). Total mortality of patients with stroke were much higher than that of non-stroke patients(P<0.01). Cox regression showed major risk factors that predisposed to stroke were history of stroke(RR=2.329, 95% CI:1.343-4.041), sustained chest pain at admission (RR=1.957, 95%CI:1.261-3.037), history of hypertension (RR=1.848, 95% CI:1.153-2.963), re-hospitalization during follow-up period (RR=1.823, 95%CI:1.122-2.960) and age (RR=1.056, 95%CI:1.031-1.081). Protective factors that reduced stroke were the frequency of using nitrate during follow-up period (RR=0.803, 95% CI: 0.665-0.969), using of nitrate before admission (RR=0.537, 95% CI: 0.346-0.834). Conclusions Non-ST segment elevation ACS patients with stroke had higher mortality. Previous history of stroke, sustained chest pain at admission, history of hypertension, older age were risk factors for stroke in patients with non-ST segment elevation ACS.
中文关键词	非ST段抬高急性冠状动脉综合征 ; 脑卒中 ; 危险因素 ; Cox回归分析
英文关键词	Non-ST elevation acute coronary syndrome Risk factors Stroke Cox regression
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL ; CLINICAL NEUROLOGY
WOS研究方向	General & Internal Medicine ; Neurosciences & Neurology
CSCD记录号	CSCD:2938024
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/221898
作者单位	1.中国医学科学院阜外心血管病医院,急症抢救中心, 北京 100037, 中国; 2.中国医学科学院阜外心血管病医院,高血压中心, 北京 100037, 中国
推荐引用方式 GB/T 7714	王曼,朱俊,谭慧琼,等. 非ST段抬高急性冠状动脉综合征患者脑卒中事件[J],2007,15(10):853-858.
APA	王曼,朱俊,谭慧琼,梁岩,章晏,&刘力生.(2007).非ST段抬高急性冠状动脉综合征患者脑卒中事件.,15(10),853-858.
MLA	王曼,et al."非ST段抬高急性冠状动脉综合征患者脑卒中事件".15.10(2007):853-858.