急性缺血性中风与左心室缩功能障碍之间的关系
M Saiduzzaman1, S Dey, M Bhattacharjee
1Dr Md Saiduzzaman, Medical Officer, Department of Neurology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh;
Mymensingh medical journal : MMJ
|October 1, 2023
概括
轻度至中度的左心室缩功能障碍 (LVSD) 增加了急性缺血性中风的风险. 在中风患者中,较低的LVEF与更严重的神经缺陷相关,突出显示LVSD是中风发展和严重性的关键因素.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 在全球范围内,中风是导致死亡和残疾的主要原因,缺血性中风占病例的80-85%.
- 虽然明显的心力衰竭预示着不良结果,但轻度至中度的左心室缩功能障碍 (LVSD) 与急性缺血性中风 (AIS) 风险之间的联系仍未得到充分研究.
- 了解LVSD和AIS之间的关联对于改善中风预防和管理策略至关重要.
研究的目的:
- 调查LVSD与AIS发生之间的关系.
- 评估LVSD与AIS患者神经缺陷严重程度之间的关联.
- 为了确定轻度至中度的LVSD是否是AIS的独立风险因素.
主要方法:
- 一项病例控制研究涉及120名首次患有AIS的患者和120名年龄/性别匹配的健康对照.
- 评估左心室 (LV) 缩功能,使用胸前两维心声谱来确定左心室喷射率 (LVEF).
- 使用美国国立卫生研究院中风严重程度尺度 (NIHSS) 测量中风严重程度.
主要成果:
- 与对照组相比,LVSD在AIS患者 (23.3%) 的患病率显著更高 (5.8%,p<0.001).
- 轻度和中度的LVSD与AIS的几率明显更高 (OR分别为3.48和9.74).
- 在对其他风险因素进行调整后,LVSD仍然是AIS的独立风险因素 (OR 2.7462,p=0.0435).
- NIHSS得分显示,与LVEF的显著负相关性 (r=-0.443,p<0.001),表明较低LVEF的神经缺陷较大.
结论:
- 轻度至中度的LVSD与急性缺血性中风的风险增加显著相关.
- 对于AIS来说,LVSD是一个独立的风险因素,即使考虑到其他常见的风险因素.
- 在AIS患者中,较低的LVEF与更严重的神经缺陷相关,强调心脏功能障碍对中风结果的影响.
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