Comparative Analysis Of Clinical Characteristics And Risk Factors Of Cerebral Infarction Patients With Atrial Fibrillation And Non Atrial Fibrillation

[Objective]By analyzing and comparing clinical characteristics and risk factors of cerebral infarction patients with atrial fibrillation(AF)and non atrial fibrillation(the control group),this article summarizes the main differences between these two groups and the recurrence risk factors of cerebral infarction with AF,so as to guide the clinical pathogeny analysis of cerebral infarction with AF and provide references for the primary and secondary prevention and treatment[Methods]By the approach of retrospective analysis,we selected 409 cases of cerebral infarction as research object from Anshan Changda Hospital(Three-B Hospital)Neurology Department in the period of June-December 2019,who were all confirmed as cerebral infarction by CT or MRI.56 in 409 cases are with AF,and 353 cases are without AF.According to the Exclusion Criteria,12 cases and 30 cases are excluded respectively.Eventually,a total of 367 cases are valid,which include of 44 cases in the AF group and 323 cases in the control group.A comparison of clinical characteristics and related risk factors is made in both groups,specifically analyzing past medical history,personal history,clinical symptoms,infarction area,related laboratory tests,indicators of color doppler echocardiography,etc.Furthermore,the AF group is divided into 2 groups(the first onset group and the recurrent group),and the related risk factors mentioned above are retrospectively compared.[Results]1.In the aspect of clinical characteristics,this study comes to a conclusion that neurological function damage and self-care ability loss in the AF group are more serious than in the control group.The NIHSS(National Institutes of Health Stroke Scale)score,MRS(Modified Rankin Scale)score,hospital stay and hospitalization expenses of the AF group are higher(P<0.001).And significant differences are found between the AF group and the control group in the aspect of signs such as gaze,aphasia,disturbance of consciousness,and cognitive disorder(P<0.05).And posterior circulation infarction is more likely to occur in the control group(P<0.05).In the aspect of risk factors,there is no big difference in the aspect of age,gender,hypertension,coronary heart disease,history of stroke,cholesterol,HDL-C,LDL-C,Uric Acid,fibrinogen,Homocysteine,triglyceride,creatinine,urea nitrogen,and ALT between the two groups(P>0.05).And significant differences are found in the aspect of cardiac insufficiency history,BNP,EF,LAD,smoking index,diabetes,AST,and glycated hemoglobin between the two groups(P<0.05).In addition,the partial stenosis rate of carotid artery in the control group is obviously higher than in the AF group(P<0.05).2.This study shows that,among so many risk factors,the duration of AF,high levels of glycated hemoglobin,and the AF ventricular rate are recurrence risk factors of cerebral infarction with AF in the univariate analysis.However,in the Logistic regression analysis,only the duration of AF(OR=4.621,95%CI 1.832～11.812)and the ventricular rate of AF(OR=2.811,95%CI 1.022～7.821)are the independent risk factors for recurrence.[Conclusion]1.The similarities and differences of risk factors mentioned above may indicate that the pathogenesis for the cerebral infarction patients with AF involves not only the general acknowledged mechanism of cerebral embolism caused by cardiac embolic loss,but also several other mechanisms including changes of hemorheology,hemodynamic abnormalities,and atherosclerotic plaque formation or detachment based on the intracranial and extracranial artery atherosclerosis.2.In the primary and secondary prevention and treatment to cerebral infarction with AF,we should comprehensively and scientifically control the risk factors of atherosclerosis,make an anticoagulant therapy to improve hemorheological indexes,and improve blood flow by taking control of heart failure and ventricular rhythm.