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Re:【medical-news】心房颤动不是高龄人群痴呆的危险因素

初译:

Atrial Fibrillation Not a Risk Factor for Dementia in Very Elderly
心房颤动不是高龄人群痴呆的危险因素

NEW YORK (Reuters Health) May 10 - While atrial fibrillation is a significant risk factor for stroke in the very old, it does not predict dementia, according to findings published in the May issue of Stroke.
纽约(路透通讯社健康报道)5月10日-5月的《卒中》期刊上报道:心房颤动是老年中风患者的重要危险因素,但其不能预测痴呆的发生。

"Atrial fibrillation (AF) is a well-known risk factor for stroke in the elderly," Dr. Tuula Pirttila, of Kuopio University Hospital, Finland, and colleagues write. "Several studies have shown that AF predicts the development of poststroke dementia, whereas others have found no such association."
芬兰Kuopio大学医学院的Tuula Pirttila医师称“心房颤动是老年中风患者显著的危险因素”,他的同事表明“几项研究曾显示心房颤动可预测中风后痴呆的发生,但其他的研究则未发现两者间存在联系。”

In a prospective 9-year population-based study in Vantaa, a town in Southern Finland, the researchers examined the association between AF, stroke, dementia, and their correlation with brain pathology in subjects 85 years of age or older.
在芬兰南部的Vantaa小镇,研究者通过一项以人群为基础为期9年的前瞻性研究来探讨在85岁老年人当中心房颤动,中风,痴呆以及它们之间伴随脑部病理改变的联系。

A total of 553 subjects were examined by a neurologist. The diagnosis of AF was made by ECG or medical record review. During a mean follow-up of 3.5 years, 479 subjects died, and postmortem neuropathological examinations were performed in 306.
一位神经病学家检查总计553名纳入研究者。通过心电图或诊疗记录检查来诊断心房颤动。平均随访时间为3.5年,479例死亡以及306例于死后尸检行神经病理检查。

Overall, 122 subjects (22.1%) were diagnosed with AF. A significant association was observed between AF and stroke at baseline. Stroke was present in 39 (32%) of 122 subjects with AF and in 72 (16.7%) of 431 subjects without AF (p < 0.001).
总计122名纳入研究者(22.1%)诊断为心房颤动。在试验开始时点心房颤动和中风之间可观察到显著相关。122名纳入诊为心房颤动研究者中39例(32%)存在中风,而在431例纳入的非心房颤动研究者中72例(16.7%)存在中风(两者比较p < 0.001)。

"Dementia at baseline was much more common in subjects who had clinical stroke than among others (71.2% versus 30.5%)," the investigators report, but dementia prevalence did not differ between those with or without AF.
研究者报道,“在临床试验开始时点存在临床中风的受试患者痴呆较其他患者普遍(71.2%对比30.5%),但痴呆在存在心房颤动和无心房颤动的受试者之间并无区别。

During follow-up, 100 new dementia cases occurred. Again, the incidence of dementia was statistically the same in those with and without AF, at 16.4% and 18.6%, respectively.
在随访期间,新出现的100例痴呆患者再次发病,在有无心房颤动的纳入研究者中统计痴呆的发生率是一样的,分别为16.4%和18.6%。

"Clinically diagnosed dementia (at baseline or during the follow-up) was significantly associated with education (OR, 0.89; p = 0.019), beta-amyloid load in the brain (OR, 1.26; p < 0.001), and with vascular pathology (OR, 2.03; p = 0.016), but not with sex, age at death, or APOE e4 allele," Dr. Pirttila's team reports.
Pirttila医师的研究小组报告“临床痴呆的诊断(在临床试验始点或随访期间)与教育(OR值,0.89;p = 0.019),脑部β-淀粉蛋白含量(OR值,1.26;p < 0.001)以及血管病理(OR值,2.03;p = 0.016)显著相关,但与性别,死亡年龄或者等位基因的载脂蛋白e4无关。”

They conclude that AF can be considered a contributor to dementia in the very old, through its relation to stroke, but "it is not an independent predictor of dementia."
研究者得出结论,心房颤动可被认为是导致老年人痴呆的因素,尽管其与中风相关,但“心房颤动不是预测痴呆的独立因素。”

Stroke 2007;38:1454-1460.

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编译投稿:(700字)

纽约路透通讯社5月10日健康报道:5月的《卒中》期刊上报道:心房颤动是老年中风患者的重要危险因素,但其不能预测痴呆的发生。研究的背景是既往认为心房颤动是老年中风患者显著的危险因素,几项研究曾显示心房颤动可预测中风后痴呆的发生,但其他的研究则未发现两者间存在联系。在芬兰南部的Vantaa小镇,芬兰Kuopio大学医学院的Tuula Pirttila医师领导研究小组通过一项以人群为基础为期9年的前瞻性研究来探讨在85岁老年人当中心房颤动,中风,痴呆以及它们之间伴随脑部病理改变的联系。小组中的一位神经病学家检查总计553名纳入研究者。通过心电图或诊疗记录检查来诊断心房颤动。平均随访时间为3.5年,479例死亡以及306例于死后尸检行神经病理检查。结果显示,总计122名纳入研究者(22.1%)诊断为心房颤动。在试验开始时点心房颤动和中风之间可观察到显著相关。122名纳入诊为心房颤动研究者中39例(32%)存在中风,而在431例纳入的非心房颤动研究者中72例(16.7%)存在中风(两者比较p < 0.001)。研究者报道,“在临床试验开始时点存在临床中风的受试患者痴呆较其他患者普遍(71.2%对比30.5%),但痴呆在存在心房颤动和无心房颤动的受试者之间并无区别。在随访期间,新出现的100例痴呆患者再次发病,在有无心房颤动的纳入研究者中统计痴呆的发生率是一样的,分别为16.4%和18.6%。Pirttila医师的研究小组报告“临床痴呆的诊断(在临床试验始点或随访期间)与教育(OR值,0.89;p = 0.019),脑部β-淀粉蛋白含量(OR值,1.26;p < 0.001)以及血管病理(OR值,2.03;p = 0.016)显著相关,但与性别,死亡年龄或者等位基因的载脂蛋白e4无关。” 研究者由此得出结论,心房颤动可被认为是导致老年人痴呆的因素,尽管其与中风相关,但“心房颤动不是预测痴呆的独立因素。”
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