心房颤动发病相关因素的临床研究  

Clinical study on the correlative factors of atrial fibrillation

作　　者：李世敬[1] 李学斌[2] 王军[2] 王德昭[3] 郭继鸿[2] 

机构地区：[1]北京市门头沟区医院,102300 [2]北京大学人民医院,100044 [3]首都医科大学附属北京天坛医院,100050

出　　处：《临床心电学杂志》2013年第2期106-109,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨幽门螺杆菌(Helicobacter pylori,Hp)感染、高敏-CRP(High sensitivity C-reactiveprotein,Hs-CRP)水平、左心房内径(Lef tatriumdiameter,LAD)与房颤的相关性。方法回顾性分析2007年1月至2012年12月在我院住院治疗的房颤患者262例,非房颤患者115例;所有病例均行13C呼气试验测定、血浆幽门螺杆菌抗体(HpIgG)测定、Hs-CRP水平测定及超声心动检查。结果①心房颤动组13C呼气试验幽门螺杆菌、hs-CRP、左心房内径阳性率明显高于非心房颤动组(p<0.05);②心房颤动组13C呼气试验幽门螺杆菌感染δ值、hs-CRP以及左心房内径水平明显高于非心房颤动组(p<0.05);③首发房颤、阵发性房颤、持续性房颤、长程持续性房颤以及永久性房颤5个亚组分别两两比较:永久性房颤组Hpδ值高于初发房颤组、阵发性房颤组及持续性房颤组(p<0.05);永久性房颤组hs-CRP水平高于首发房颤组、阵发性房颤组及持续性房颤组(p<0.05);长程持续性房颤组hs-CRP水平高于首发房颤组、阵发性房颤组(p<0.05);永久性房颤组左心房内径水平高于首发房颤组、阵发性、持续性房颤组(p<0.05);④综合HP感染、hs-CRP、左心房内径及其他危险因素后,发现Hp≥4‰、hs-CRP>5mg/L以及左心房内径≥36mm与心房颤动较强的相关性(p<0.05)。结论 HP感染、hs-CRP升高、左心房内径增大均可反应房颤的发生率;Hp≥4‰、hs-CRP>5mg/L、左心房内径≥36mm均是患者心房颤动的敏感指标。Objective To explore the correlation between atrial fibrillation and helicobacter pylori infection, hs-CRP level as well as left atrial diameter. Methods 13C-Breathtest, Hp, IgG, antibody, hs-CRP and Echoeardiography were analyzed in 262 patients with AF and 115 without AF. All patients also underwent medical history collection, physical examination, blood routine, biochemical, UMA, glyeosylated hemoglobin, HCY, fundus photography, ABI and BaPWV test. Results ①The positive rates of C-Breathtest,hs-CRP and left atrial diameter in AF group were significantly higher than that of non-AF group （0〈0.05）; ②δ value of 13C- Breathtest,hs-CRP and left atrial diameter level in AF group were significantly higher than that of non-AF group （0〈0.05）; ③Five subgroups were compared in pairs-first diagnosed AF, paroxysmal AF, persistent AF, long-standing persistent AF and permanent AF： δvalue of 13C-Breathtest was significantly higher in permanent AF than in first diagnosed AF, paroxysmal AF and persistent AF （0〈0.05）; level of hs-CRP was significantly higher in long-standing persistent AF than in first diagnosed and paroxysmal AF （0〈0.05）; the left atrial diameter was significantly increased in permanent AF than in first diagnosed AF, paroxysmal AF and persistent AF （0〈0.05）. ④Mading a synthesis of Hp infection, hs-CRP, left atrial diameter level and other risk factors. Conclusion Hp infection, hs-CRP elevation and left atrial diameter increasing could reflect on the prevalence of atrial fibrillation; Hp ≥4‰, hs-CRP〉5mg/L and left atrial diameter ≥ 36mm would be sensitive indicators of AF.

关 键 词：幽门螺杆菌感染 左心房内径 心房颤动 13C呼气试验 

分 类 号：R541.75[医药卫生—心血管疾病]