冠状动脉旁路移植术后心房颤动的发生率及其危险因素分析  

The incidence and risk factors of atrial fibrillation following coronary artery bypass grafting

作　　者：沈童童[1] 单其俊[1] 袁彪[1] 杨兵[1] 徐东杰[1] 陈椿[1] 邹建刚[1] 陈明龙[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏科,江苏南京210029

出　　处：《中国心脏起搏与心电生理杂志》2007年第3期215-218,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：江苏省135工程个人项目

摘　　要：目的调查冠状动脉旁路移植术(CABG)后心房颤动(AF)的发生率并分析其危险因素。方法回顾性分析312例行CABG的病例资料,根据术后住院期间(1～3周内)有无AF发生将其分为AF组与非AF组,比较两组临床资料,进行统计学分析,筛选CABG术后AF的独立危险因素。结果103例于CABG术后发生AF,其发生率为33.01%。单因素分析显示AF组高龄(≥70岁)、术后早期停用β受体阻滞剂、高血压、左房内径增大(≥40mm)、AF病史、术前P波时限≥120ms以及血管桥数目≥3支的患者比例明显高于非AF组(P<0.05)。多因素回归分析显示高龄(≥70岁)、术后早期停用β受体阻滞剂、高血压、左房内径增大(≥40mm)以及AF病史与CABG术后AF有高度相关性。结论CABG术后AF的发生率为33.01%。高龄、术后早期停用β受体阻滞剂、高血压、左房内径增大和AF病史是CABG术后AF的独立危险因素。Objective To investigate the incidence and relative risk factors of atrial fibrillation （AF） following coronary artery bypass grafting （CABG）. Methods 312 patients with CABG were reviewed and divided into AF group and non-AF group on the basis of whether AF occurred postoperatively during hospital stay （within 1 - 3 weeks）. Statistical analysis was used to screen for risk factors of AF following CABG. Results 103/312 （33. 01% ） patients developed post- CABG AF. Univariate analysis showed that the cases of advanced age （ ≥70 years）, early postoperative withdrawal of 6- blockers, hypertension, left atrial enlargement （ ≥40 mm） and a history of AF, prolonged P-wave duration （ ≥ 120 ms）, numerous grafting （ ≥3 ） in AF group were more than those in non-AF group （P 〈 0. 05 ）. Multivariate logistic regression analysis showed that advanced age （ ≥70 years）, early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement （ ≥40 mm） and a history of AF were highly related to AF following CABG. Conclusions The incidence of AF in patients following CABG is 33. 01% in this study. Advanced age, early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement and a history of AF are independent risk factors of AF following CABG. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2007 ,21 （3） ：215 -218 ]

关 键 词：心血管病学 冠状动脉旁路移植术 心房颤动 危险因素 

分 类 号：R541.75[医药卫生—心血管疾病]