代谢综合征对冠心病患者心房纤颤的影响  

Relationship between metabolic syndrome and increased risk of atrial fibrillation in patients with coronary heart disease

作　　者：李慧[1] 拓步雄[1] 李超民[1] 彭利静[1] 钟筱兰[1] 

机构地区：[1]解放军第四五一医院心血管内科,陕西西安710054

出　　处：《心脏杂志》2010年第6期884-886,890,共4页Chinese Heart Journal

摘　　要：目的:探讨代谢综合征(MS)与冠心病患者心房纤颤(AF)发生的关系。方法:入选住院拟行选择性冠状动脉造影(CAG),并确诊为冠心病(CHD)的患者1 805例,分为非MS组(n=1 150)及MS组(n=655),比较两组的相关临床资料,超声心动图及AF的情况。结果:MS组患者AF发生率明显高于非MS组(14.2%vs.8.1%,P<0.01),MS组左房内经(LAD),左室舒张末期内径(LVEDD)、左室壁厚度(LVPW),左室质量(LVM),左室质量指数(LVMI)均高于非MS组(P<0.05),左室射血分数(LVEF)明显低于非MS组(P<0.01)。Logistic回归分析显示冠心病患者发生AF的危险与年龄,左房增大、左室扩大及并发MS明显相关(OR分别为1.666、4.446、1.950、1.636,均P<0.05)。AF(n=188)与无AF患者(n=1 617)相关指标、单因素分析发现AF组MS发生率明显高于无AF组(49.3%vs.4.5%,P<0.01),体质量指数(BMI)、空腹血糖(FPG)水平明显升高(均P<0.05)。进一步Logistic回归分析显示MS组中肥胖与AF的发生关系最密切(OR:1.911,P<0.01)。结论:MS与冠心病患者发生AF的危险关系密切。AIM： To explore the effect of metabolic syndrome （MetS） on atrial fibrillation （AF） in coro- nary heart disease （CHD） patients. METHODS： A cross-sectional study was conducted in a cohort of 1805 hospitalized CHD patients who were divided into CHD ＋ non-MetS group （n = 1 150） and CHD ＋ MetS group （n = 655） according to MetS criteria. RESULTS： Incidence of AF in CHD ＋ MetS group was higher than that in CHD ＋ non-MetS group （ 14.2% vs. 8. 1% , P 〈 0. 01 ）. Left atrial diameter （ LAD）, left ventrieular end-diastolic diameter （ LVEDD）, interventricular septum thickness （ IVS）, left ventricular posterior wall thickness （LVPW）, left ventricular mass （LVM） and left ventricular mass index （LVMI） were higher in CHD ＋ MetS group than those in CHD ＋ non-MetS group （P 〈 0. 05）, whereas left ventricular ejection fraction （LVEF） was lower （P 〈0. 01 ）. After adjustment for age, LAD and LVEDD, logistic regression analysis showed that MetS predicted the incidence of AF in CHD patients （OR： 1. 631, P〈0. 05）. AF patients （n = 188） were more likely to be complicated with MetS than non-AF patients （n = 1 617, 49.3% vs. 34.5%, P 〈 0.01 ） with higher body mass index （BMI） and fasting plasma glucose （FPG）（P 〈0. 05）. Further logistic regression analysis suggested that obesity was the most closely related independent predisposing risk factor for AF （OR： 1. 911, P 〈 0. 01 ）. CONCLUSION： MetS is closely associated with the incidence of AF in CHD patients. Obesity is the most closely related predisposing factor for AF among all MetS factors.

关 键 词：冠状动脉疾病 代谢综合症 心房颤动 

分 类 号：R541.4[医药卫生—心血管疾病] R541.7[医药卫生—内科学]