非瓣膜性心房颤动作为老年人致命性大面积脑梗死的一个病因
Nonvalvular atrial fibrillation as a cause of fatal massive cerebral infarction in the elderly.
作者信息
Yamanouchi H, Tomonaga M, Shimada H, Matsushita S, Kuramoto K, Toyokura Y
机构信息
Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Japan.
出版信息
Stroke. 1989 Dec;20(12):1653-6. doi: 10.1161/01.str.20.12.1653.
By studying 3,408 consecutive autopsied elderly patients, we found that two thirds of the 132 massive cerebral infarctions (86) were embolic, of cardiac origin. Embolic infarction associated with nonvalvular atrial fibrillation was seen in 48 cases (36%), half due to the first stroke. Embolic infarction associated with heart disease other than nonvalvular atrial fibrillation was seen in 23 cases (17%), and that from nonbacterial thrombotic endocarditis was seen in 15 cases (11%). Thrombotic infarction or infarction of nonembolic cardiac origin was found in only 39 cases (30%). Of 56 patients with fatal massive cerebral infarction who died less than or equal to 2 weeks after their stroke, 25 (45%) had embolic strokes associated with nonvalvular atrial fibrillation. Our study shows that nonvalvular atrial fibrillation is a very important cause of fatal massive cerebral infarction in the elderly.
通过对3408例连续尸检的老年患者进行研究，我们发现132例大面积脑梗死中有三分之二（86例）为栓塞性，起源于心脏。48例（36%）出现与非瓣膜性心房颤动相关的栓塞性梗死，其中一半是首次中风所致。23例（17%）出现与非瓣膜性心房颤动以外的心脏病相关的栓塞性梗死，15例（11%）出现非细菌性血栓性心内膜炎所致的栓塞性梗死。仅39例（30%）发现血栓性梗死或非栓塞性心脏起源的梗死。在中风后2周内死亡的56例致命性大面积脑梗死患者中，25例（45%）有与非瓣膜性心房颤动相关的栓塞性中风。我们的研究表明，非瓣膜性心房颤动是老年患者致命性大面积脑梗死的一个非常重要的原因。
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