冠心病患者脑卒中既往史与临床表现的相关性研究
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江南大学附属中心医院(无锡市第二人民医院)临床医学研究中心

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无锡市双百医疗卫生拔尖人才;无锡市卫健委科研项目


A study on the correlation between stroke history and clinical manifestations in patients with coronary heart disease
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Wuxi Double Hundred Medical and Health Top Talents ;Research project of Wuxi Municipal Health Commission

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    摘要:

    目的:探讨冠心病患者脑卒中既往史与心梗临床特征以及NYHA(New York Heart Association,美国纽约心脏病学会)心功能分级之间的关系。 方法:选取2018年9月至2021年9月在江苏省人民医院和无锡市第二人民医院住院的2327例冠心病患者,对患者的冠心病的心梗临床特征及一般资料进行收集。根据冠心病患者的临床特征进行分组,分为心绞痛组和心肌梗死组;NYHA分级分组为小于三级为一组,三级及以上为一组。采用多因素Logistic回归分析评估脑卒中既往史与冠心病患者临床特征以及NYHA心功能分级之间的关系。 结果:在本研究中共有冠心病患者2327例,其中有脑卒中既往史患者280例,无脑卒中既往史患者2047例。患者的一般特征中,年龄、收缩压、TC、TG、LDL、HDL、CRP、糖尿病、高血压以及肾功能不全病史在有无脑卒中既往史的患者中差异有统计学意义(P均<0.05)。通过对年龄、性别以及BMI等重要协变量进行调整后的多因素 Logistic 回归分析结果显示,脑卒中既往史与冠心病患者NYHA心功能分级独立相关(OR为1.85, 95%CI为1.14-3.01, P=0.013)。在亚组分析中进一步证实了脑卒中既往史与冠心病患者NYHA心功能分级的之间的相关性。 结论:脑卒中既往史与冠心病患者的心功能分级密切相关,可能对冠心病患者的心功能分级具有潜在的提示作用。

    Abstract:

    Objective: To explore the relationship between past history of stroke and clinical features of heart attack and NYHA (New York Heart Association, American Society of Cardiology) cardiac function grading in patients with coronary heart disease. Method: This study included a total of 2327 coronary heart disease patients who were hospitalized at Jiangsu Provincial People's Hospital and Wuxi Second People's Hospital from February 2019 to September 2021. The clinical manifestations and general information of coronary heart disease were collected. According to the clinical characteristics of coronary heart disease patients, they are divided into angina group and myocardial infarction group; The NYHA functional classification is divided into groups of less than three levels, and groups of three levels and above. Use multiple logistic regression analysis to evaluate the relationship between stroke history, clinical characteristics of coronary heart disease patients, and NYHA functional classification. Perform statistical analysis on the data using SPSS 20.0, with P<0.05 indicating statistical significance. Result: In this study, there were 2327 patients with coronary heart disease, including 280 patients with a history of stroke and 2047 patients without a history of stroke. In the general characteristics of patients, age, systolic blood pressure, TC, TG, LDL, HDL, CRP, diabetes, hypertension and renal insufficiency history were significantly different among patients with or without past stroke history (P<0.05). The results of a multivariate logistic regression analysis adjusted for important covariates such as age, gender, and BMI showed that a history of stroke was independently correlated with NYHA functional classification in patients with coronary heart disease (OR=1.85, 95% CI=1.14-3.01, P=0.013).The correlation between stroke history and NYHA functional classification in coronary heart disease patients was further confirmed in subgroup analysis. Conclusion: Past history of stroke is closely associated with cardiac function classification in patients with coronary heart disease, which may have a potential suggestive role for cardiac function classification in patients with coronary heart disease.

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  • 收稿日期:2024-10-11
  • 最后修改日期:2025-02-28
  • 录用日期:2025-05-19
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