非瓣膜性心房颤动患者血管性痴呆危险因素的病例对照研究

目的 探讨非瓣膜性心房颤动（房颤）患者血管性痴呆的危险因素，评估不同抗凝药物与心房颤动患者发生血管性痴呆的关系。方法 采用病例对照研究，选取血管性痴呆的非瓣膜性房颤患者66例（病例组）。对照组为未患血管性痴呆的非瓣膜性房颤患者132例。比较2组患者年龄、性别、体质量指数（BMI）、教育水平、吸烟等一般情况以及糖尿病、高...

Risk factors for vascular dementia in patients with nonvalvular atrial fibrillation: a case-control study

Objective To investigate the risk factors of vascular dementia in patients with nonvalvular atrial fibrillation, and to evaluate the relationship between different anticoagulants and vascular dementia in patients with atrial fibrillation. Methods A case-control study was conducted in 66 patients with nonvalvular atrial fibrillation and vascular dementia (the case group). The control group included 132 patients with nonvalvular atrial fibrillation and without vascular dementia. Data of age, sex, body mass index (BMI), education level, smoking and other general conditions including disease history of diabetes, hypertension, angina pectoris, chronic obstructive pulmonary disease (COPD), hyperthyroidism, hypothyroidism, myocardial infarction, dyslipidemia and anticoagulant drug use were compared between the two groups. Results There were no significant differences in age, gender, incidence of obesity and average education years between the two groups (P>0.05). The proportion of smoking and utilization rate of warfarin was significantly higher in the case group than that in the control group (P<0.05). The incidence of hypertension, diabetes, angina pectoris and dyslipidemia were significantly higher in the case group than those in the control group (P<0.05). Logistic regression analysis showed that the risk of vascular dementia was lower in patients taking rivaroxaban anticoagulant therapy than that in patients taking warfarin (OR=0.480, 95%CI: 0.244-0.944). Diabetes mellitus (OR=2.117, 95%CI: 1.080-4.149), hypertension (OR=2.224, 95%CI: 1.109-4.461), smoking (OR=2.269, 95%CI: 1.148-4.488), dyslipidemia (OR=2.045, 95%CI: 1.037-4.032) and history of angina pectoris (OR=2.336, 95%CI: 1.165-4.682) were risk factors for vascular dementia in patients with nonvalvular atrial fibrillation (P<0.05). Conclusion Compared with warfarin, rivaroxaban anticoagulant therapy is a protective factor for vascular dementia in patients with nonvalvular atrial fibrillation, while diabetes, hypertension, smoking, dyslipidemia and history of angina are risk factors for vascular dementia in patients with nonvalvular atrial fibrillation.