脑卒中既往史与冠心病患者临床表现的相关性研究
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1.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 ; 2. 心血管内科,江苏 无锡 214000 ; 3.南京医科大学第一附属医院心血管内科,江苏 南京 210029

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无锡市双百医疗卫生拔尖人才(BJ2023029,HB2023023);无锡市卫健委科研项目(M202207);无锡市第二人民医院高层次人才科研经费


A study on the correlation between stroke history and clinical manifestations in patients with coronary heart disease
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1.Clinical Research Center ; 2. Department of Cardiology,Jiangnan University Medical Center(Wuxi No.2 People’sHospital),Wuxi 214000 ; 3.Department of Cardiovascular,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ,China

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    摘要:

    目的:探讨脑卒中既往史与冠心病患者临床表现的相关性。方法:选取2018年9月—2021年9月在南京医科大学第一附属医院和无锡市第二人民医院住院的2 327例冠心病患者,收集患者临床特征及一般资料。根据有无脑卒中既往史将患者分为两组:卒中组和非卒中组。根据美国纽约心脏病学会(New York Heart Association,NYHA)分级,分为Ⅲ级以下组,Ⅲ 级及以上组。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表现的关系。结果:本研究共纳入冠心病患者2 327例,其中有脑卒中既往史患者280例,无脑卒中既往史患者2 047例。两组患者总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、糖尿病、高血压以及肾功能不全病史的差异均有统计学意义(P均<0.05)。通过对年龄、性别以及体重指数(body mass index,BMI)等重要协变量进行调整后,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 心功能分级独立正相关(OR=1.85,95%CI:1.14~3.01,P= 0.013)。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提示作用。

    Abstract:

    Objective:To investigate the correlation between a history of stroke and the clinical manifestations in patients with coronary heart disease(CHD). Methods:A total of 2 327 CHD patients hospitalized at the First Affiliated Hospital of Nanjing Medical University and Wuxi Second People’s Hospital from September 2018 to September 2021 were enrolled. The clinical manifestations and general information of the patients were collected. Patients were divided into two groups based on their history of stroke:the stroke group and the non-stroke group. Additionally,patients were stratified according to the New York Heart Association(NYHA)functional classification into groups with less than grade Ⅲ and grade Ⅲ or above. Multivariable logistic regression analysis was used to assess the relationship between a history of stroke and the clinical manifestations of CHD patients. Results:Among the 2 327 CHD patients, 280 had a history of stroke,while 2 047 did not. Significant differences were observed between the two groups in terms of total cholesterol (TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),diabetes,hypertension and a history of renal insufficiency(all P < 0.05). After adjusting for important covariates such as age,gender,and body mass index(BMI),multivariable logistic regression analysis revealed that a history of stroke was independently and positively associated with the NYHA functional classification of CHD patients (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:A history of stroke is closely associated with functional classification of CHD patients,and may potentially serve as an indicator for the functional status of patients with CHD.

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陈琦,刘侨,王净,王俊宏,韩志君,章丽珠,张凯欣,高明珠.脑卒中既往史与冠心病患者临床表现的相关性研究[J].南京医科大学学报(自然科学版),2025,(5):612-618

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  • 收稿日期:2024-10-11
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  • 在线发布日期: 2025-05-18
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