慢性肾脏疾病与心房颤动的患病率  

Prevalence and risk factors of atrial fibrillation in hospitalized patients with chronic kidney disease

作　　者：王骄[1] 陈一川[2] 杜华安[3] 李晓丽[1] 梅霞[1] 殷跃辉[3] 

机构地区：[1]重庆市中山医院心血管内科,400010 [2]重庆市第三人民医院肾脏内科 [3]重庆医科大学附属二院心血管内科

出　　处：《中华心血管病杂志》2013年第5期390-393,共4页Chinese Journal of Cardiology

摘　　要：目的心房颤动（房颤）是普通人群中最常见的持续性心律失常，其与慢性肾脏疾病（CKD）具有一些共同的危险因素，探讨我国CKD与帚患房颤的关系。方法1168例CKD住院患者被纳入研究，平均年龄（63．3±14．2）岁，男性占54．5％。房颤由心电图或既往确切病史判定。比较不同年龄、性别及估算肾小球滤过率（eGFR）各亚组房颤的患病率。多元logistic回归分析与房颤发生的关联因素。结果平均eGFR为（22．2±19．7）ml·min·1．73m，84．2％的研究对象eGFR≤45ml·min·1．73m，38．5％的为血液透析患者。60岁以上的患者占66．9％，房颤患病率为17．2％。与eGFR〉45ml·min-1·1．73m-2患者相比，eGFR≤45ml·min-1·1．73m-2患者房颤的患病率更高（15．8％比5．4％，P〈0．001）。多元logistic回归分析显示年龄、体质指数、心力衰竭、左房前后径、eGFR和透析与房颧发生显著相关；性别、吸烟、高血压、糖尿病与房颤无显著相关性。结论年龄、体质指数、心力衰竭、左心房径、eGFR和透析与房颤显著相关。Objective Atrial fibrillation （AF） is the most common sustained taehyarrhythmia in the general population. AF and Chronic Kidney Disease （CKD） share several common risk factors. We investigated the association between chronic kidney disease and risk of atrial fibrillation in hospitalized patients with CKD. Methods One thousand one hundred and sixty-eight patients [ （63.3 ＋ 14. 2 ） years, 54. 5% males] hospitalized CKD patients were included. AF was determined by electrocardiogram or medical history. The prevalence of atrial fibrillation was compared in CKD patients with various age, sex and glomerular filtration rate （eGFR）. Binary logistic regression analysis was used to determine the risk factors olAF. Result The mean eGFR was （22.2_＋19.7）ml.min I . 1.73 m-2; eGFRwas ~〈45 ml-min-I . 1.73 m 2 in 84. 2% patients and 38. 5% patients received hemodialysis. AF was present in 14. 2% of the study population and 17.2% in patients 〉160 years old. Prevalence of AF was significantly higher in patients with eGFR〈45 ml rain-1 1.73 m-2 compared patients with eGFR 〉45 ml rain-1 1.73 m 2（15.8% vs. 5.4%, P 〈 0. 001 ）. Binary logistic regression analysis showed that age, body mass index （BMI）, heart failure （HF）, left atrial diameter （LAD）, eGFR and dialysis were independent risk factors for AF. Conclusions AF is much more frequent in CKD patients than in the general population. Age, BMI, HF, LAD, eGFR and dialysis are risk factors for AF in hospitalized patients with CKD.

关 键 词：心房颤动 肾功能衰竭 慢性 透析 

分 类 号：R692[医药卫生—泌尿科学]