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目的:评价在我国人群中心电图左室肥厚对脑卒中(包括动脉粥样硬化性血栓性脑梗死、腔隙性脑梗死、脑出血亚型)发病的风险和脑卒中患者长期心脑血管不良事件发生的风险。方法:采用多中心病例对照研究分析心电图左室肥厚与脑卒中的关系,并对脑卒中患者进行前瞻性随访,利用COX生存回归模型分析左室肥厚对心脑血管不良事件的影响。结果:共1874例初发脑卒中患者和1879例对照入选。在校正了性别、年龄、体质指数、血压、血糖、血脂因素后,心电图左室肥厚显著增加脑卒中发病的风险(P<0.01),脑卒中以及动脉粥样硬化性血栓性脑梗死亚型、腔隙性脑梗死亚型、脑出血亚型校正后的OR值分别是2.2(95%CI:1.6～3.0)、2.2(95%CI:1.6～3.1)、1.8(95%CI:1.2～2.7)、2.0(95%CI:1.3～3.0)。随访0.1～6.1(3.7±1.4)年,在校正了混杂因素后,心电图左室肥厚显著增加脑卒中患者心脑血管不良事件发生的风险(RR:1.36,95%CI:1.04～1.76,P<0.05)。结论:心电图左室肥厚不仅是我国脑卒中患者发病的独立危险因素,而且还是脑卒中患者预后不良的独立预测因素。
PURPOSE: To evaluate the risk of left ventricular hypertrophy (LVH) in patients with stroke (including atherothrombotic cerebral infarction, lacunar infarction and intracerebral hemorrhage subtypes) and long-term cardiovascular and cerebrovascular adverse events The risk of happening. Methods: A multicenter case-control study was conducted to analyze the relationship between left ventricular hypertrophy and stroke with electrocardiogram. The patients with stroke were prospectively followed up. The effects of left ventricular hypertrophy on cardiovascular and cerebrovascular adverse events were analyzed using COX survival regression model. Results: A total of 1874 patients with stroke and 1879 controls were enrolled. Left ventricular hypertrophy increased the risk of stroke (P <0.01), stroke and atherosclerotic thrombotic cerebral infarction subtypes (P <0.01) after adjusting for sex, age, body mass index, blood pressure, The odds ratios for lacunar infarction subtype and intracerebral hemorrhage subtype were 2.2 (95% CI: 1.6-3.0), 2.2 (95% CI 1.6-3.1), 1.8 (95% CI 1.2-7.7 ), 2.0 (95% CI: 1.3 ~ 3.0). Left ventricular hypertrophy of ECG significantly increased the risk of cardiovascular and cerebrovascular adverse events (RR: 1.36, 95% CI: 1.04-1.76, P <0.05) after follow-up of 0.1 to 6.1 (3.7 ± 1.4) years after adjusting for confounding factors 0.05). Conclusion: ECG left ventricular hypertrophy is not only an independent risk factor for stroke in China, but also an independent predictor of poor prognosis in patients with stroke.