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Stroke:风湿性瓣膜病与卒中后不良预后相关

2016-10-24 MedSci MedSci原创

背景:风湿性心脏瓣膜病与脑血管事件风险增加相关,有风湿性二尖瓣病变(RMVD)的卒中患者的预后的研究较少。方法: 研究者对泰国卒中队列研究中RMVD与严重和常见心血管和非心血管疾病(呼吸道感染)并发症的相关性。探讨与住院死亡率相关的因素。从国家保险数据库中获得相应的数据。当前的研究中,所有住院卒中发生在2004年10月1日至2013年1月31日。比较RMVD和非RMVD患者的特征和预后。应用逻辑回

背景:风湿性心脏瓣膜病与脑血管事件风险增加相关,关于风湿性二尖瓣病变(RMVD)的卒中患者的预后的研究较少。

方法:研究者对泰国卒中队列研究中RMVD与严重和常见心血管和非心血管疾病(呼吸道感染)并发症的相关性。探讨与住院死亡率相关的因素。从国家保险数据库中获得相应的数据。


当前的研究中,所有住院卒中发生在2004年10月1日至2013年1月31日。比较RMVD和非RMVD患者的特征和预后。应用逻辑回归,倾向得分匹配,和多变量模型评估研究预后。

结果:总的来说,共有594 681例(平均年龄[SD]= 64 [ 14.5 ]年)卒中患者(缺血性卒中= 306154;出血性卒中= 195392;原因不明者= 93135)纳入本研究,其中5461例有RMVD。初步分析结果表明,校正潜在的混杂因素后,对于缺血性卒中患者, RMVD(P<0.001)与心脏骤停(OR, [ 95%CI]:2.13 = [ 1.68-2.70 ]),休克(2.13 [ 1.64-2.77 ]),心律失常(1.70 [ 1.21-2.39 ]),呼吸衰竭(2.09 [ 1.87-2.33 ]),肺炎(2 [ 1.81-2.20 ]),败血症(1.39 [ 1.19-1.63 ])的发生增加相关。出血性脑卒中患者,RMVD与(充分校正模型)呼吸衰竭(1.26 [ 1.01-1.57 ])的发生增加相关,原因不明的卒中患者,RMVD与休克(3 [ 1.46-6.14 ])、呼吸衰竭(2.70 [ 1.91-3.79 ]),和肺炎(2.42 [ 1.88-3.11 ])的发生增加相关。

结论:RMVD与急性卒中后心脏骤停、休克、心律失常、呼吸衰竭、肺炎的发生相关。

原始出处:

Wood AD, Mannu GS,et al. Rheumatic Mitral Valve Disease Is Associated With Worse Outcomes in Stroke: A Thailand National Database Study. Stroke. 2016 Oct 4.

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