筛选心房颤动危险因素的病例对照研究  

A Case-Control Study of Screening Out Risk Factors for Atrial Fibrillation

作　　者：贺永明[1] 杨向军[1] 

机构地区：[1]苏州大学附属第一医院心内科,江苏省苏州市215004

出　　处：《中国循环杂志》2005年第2期114-117,共4页Chinese Circulation Journal

摘　　要：目的:筛选心房颤动(房颤)发生的独立危险因素并建立预测模型。方法:本研究从我院心内科病人中随机抽取房颤病人99例作为实验组,非房颤病人95例作为对照组,进行单因素分析和筛选自变量的多因素逐步回归分析。接受者工作特征(ROC)曲线分析确定白蛋白水平和左心房大小的临界值。结果:多因素逐步回归分析显示有统计学意义的危险因素按P值水平依次为左心房内径[P=0.0001,风险比值(OR)=3.024]、白蛋白水平(P=0.0200,OR=0.730)和三尖瓣关闭不全(P=0.0207,OR=1.699)。左心房内径和白蛋白水平的临界值分别为39.5mm和39.6g/L。由这3个危险因素建立的白蛋白复合模型能较准确地预测房颤的发生,符合率为84.2%。结论:白蛋白水平、左心房内径大小和三尖瓣关闭不全是预测房颤发生的独立危险因素,低自蛋白血症与房颤相关提示"营养不良性"房颤的可能。Objective:We sought to explore risk factors for atrial fibrillation(AF)and to establish an arithmetic model for prediction of AF. Methods :Ninety-nine patients with AF were selected randomly from the inpatients admitted to the Department of Internal Medicine, Cardiovascular Institute in 2002 as case group. Ninety-five patients without AF were randomized to the control group. Receiver operating characteristics curve was employed to define the cutoff points of left atrium size and albumin levels, respectively. Results:Multivariate stepwise Logistic regression analysis revealed that left atrial size, albumin levels and tricuspid insufficiency (p =0. 0001, OR =3. 024; p =0. 0200, OR =0. 730 andp =0. 0207, OR = 1. 699, respectively) according to the P values , were independent risk factors for atial fibrillation prediction with statistic significance. The cutoff points for left atrial size and albumin levels were 39. 5 mm and 39. 6 g/L, respectively. The albumin composite model based on these 3 risk factors predicted the occurrence of atrial fibrillation accurately, with the concordant rate being 84. 2%. Conclusions: Albumin levels, left atrial size and tricuspid insufficiency were the 3 most important and independent predictive risk factors for atrial fibrillation. Low albumin levels in atrial fibrillation patients indicated the possibility of malnutrition atrial fibrillation.

关 键 词：心房颤动 病例对照研究 筛选 多因素逐步回归分析 三尖瓣关闭不全 独立危险因素 左心房内径 蛋白水平 低白蛋白血症 单因素分析 左心房大小 营养不良性 预测模型 曲线分析 工作特征 临界值 实验组 内科病 对照组 自变量 

分 类 号：R541.75[医药卫生—心血管疾病] R735.2[医药卫生—内科学]