心房颤动电复律的相关因素  

Factors to predict whether electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation

作　　者：胡小菁[1] 吕安林[1] 刁繁荣[1] 李军杰[1] 胡燕[1] 温俊娜[1] 孟晓雪[1] 宋延斌[1] 杜娟娟[1] 

机构地区：[1]第四军医大学西京医院心内科,陕西西安710032

出　　处：《心脏杂志》2007年第6期689-691,共3页Chinese Heart Journal

摘　　要：目的分析影响心房颤动电复律成功的因素。方法根据房颤患者62例电复律是否成功,分为复律成功组和失败组。比较两组在性别、年龄、并发冠心病、高血压病和瓣膜性心脏病、左心房内径、左心室舒张末期内径、左心室射血分数、C反应蛋白(CRP)水平的差异。CRP检测:所有患者于入院后/入组后第2天常规空腹抽血,采用免疫比浊法测定高敏感CRP(hs-CRP)。结果与转复成功组比较,转复失败组年龄大(P<0.05),左心房内径大(P<0.05),并发瓣膜性病变比例高(P<0.05),房颤持续时间长(P<0.05),hs-CRP水平高(P<0.05)。经多因素分析,hs-CRP水平OR为2.1(95%CI1.4-3.2,P<0.01)、左房直径OR为1.8(95%CI1.2-2.2,P<0.01)和房颤持续时间OR为2.8(95%CI1.6-4.0,P<0.01)。结论hs-CRP、左房直径及房颤持续时间是影响房颤电复律成功的独立预测因素。AIM To analyze the factors that predict whether the electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation. METHODS Sixty-two patients with atrial fibrillation were divided into two groups according to the results of CV ： successful cardioversion group and unsuccessful cardioversion group. The differences of gender, age, complications with coronary heart disease （CHD）, hypertension, valvular heart disease （ VHD）, left atrial dimension （ LAD）, left ventricular end-diastolic dimension （LVEDD）, left ventricular ejection fraction （LVEF） and pre-CV CRP levels of the two groups were analyzed. Serum specimens were collected in the second day after the patients were admitted into the hospital or enrolled in the study. High sensitivity C-reactive protein was measured by latex particle-enhanced immunoturbidimetric assay. RESULTS Compared with those in the successful cardioversion group, the age was older（ P 〈 0.05 ）, LAD was larger（ P 〈 0.05 ）, CRP level was and more patients had VHD（P 〈 0.05 ）in unsuccessful cardioversion group. Muhivariable analysis showed that CRP lever OR was 2.1 （95% CI 1.4 - 3.2, P 〈 0.01 ）, LAD OR was 1.8 （95% CI 1.2 - 2.2,P 〈 0.01 ） and the duration of AF OR was 2.8 （95% CI 1.6 - 4.0, P 〈 0.01 ）. CONCLUSION Sensitive C-reactive protein level, LAD and the duration of AF are independent factors to predict whether the electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation.

关 键 词：房颤 电复律 C反应蛋白 

分 类 号：R541.7[医药卫生—心血管疾病]