Objective: To explore gender-specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients. Methods: A case-control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first-ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency-matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population-attributable risk proportion [PARP, (95%CI)] was calculated. Results: The age of male subjects in the case group and control group were (65.26±11.20) and (64.83±11.08) years old, and that of females in two groups were (63.63±10.40) and (63.93±10.35) years old. According to the PARP (95%CI), relevant factors of the onset of ischemic stroke in a descending sequence were hypertension history [35.63 (18.64-47.73)], family history of stroke [28.70 (23.63-32.30)]and physical inactivity [15.73 [5.62-23.06)] among male AF patients, and family history of stroke (29.39 (24.21-33.08)), dyslipidemia (22.17 (2.26-36.45)) and smoking [2.09 (0.76-3.24)] among female AF patients. Conclusion: The relevant factors of ischemic stroke were different between male and female AF patients.
目的： 探讨不同性别心房颤动（简称"房颤"）患者缺血型脑卒中发病的相关因素及其贡献度。 方法： 采用病例对照研究，相关数据来自中国脑卒中筛查项目数据库。以2013年9月至2015年9月于筛查当年首发缺血型脑卒中的房颤患者为病例；以年龄和城乡分布为匹配因素，按1∶3频数匹配选择该项目中从未发生脑卒中的房颤患者为对照，共纳入男性病例85例（对照320名），女性病例147例（对照484名）。采用非条件logistic回归模型分析缺血型脑卒中发病的相关因素，计算人群归因危险度百分比（PARP）及其95%CI值。 结果： 男性病例组和对照组分别为（65.26±11.20）和（64.83±11.08）岁；女性分别为（63.63±10.40）和（63.93±10.35）岁。发生缺血型脑卒中的相关因素按贡献率[PARP（95%CI）]由大到小在男性房颤患者中依次为：高血压病史[35.63（18.64~47.73）]、脑卒中家族史[28.70（23.63~32.30）]和缺乏运动[15.73（5.62~23.06）]，在女性房颤患者中依次为：脑卒中家族史[29.39（24.21~33.08）]、血脂异常[22.17（2.26~36.45）]和吸烟[2.09（0.76~3.24）]。 结论： 不同性别房颤患者缺血型脑卒中发病的相关因素不尽相同。.
Keywords: Atrial fibrillation; Case-control studies; Risk factors; Stroke.