超重和肥胖对上游治疗的老年阵发性心房纤颤复发的影响研究  

Impact of Overweight and Obesity on Recurrence of Paroxysmal Atrial Fibrillation in Elderly

作　　者：宋宏雁[1] 方志敏[1] 钟小兰[1] 刘超群[1] 陆云[1] 刘顺民[1] 

机构地区：[1]新疆医科大学第二附属医院心血管内科,新疆乌鲁木齐市830000

出　　处：《中国全科医学》2013年第35期4227-4228,共2页Chinese General Practice

摘　　要：目的探讨超重和肥胖对上游治疗的老年阵发性心房纤颤(房颤)复发的影响。方法选择我院2010年6月—2012年1月收治的老年阵发性房颤患者122例(60～80岁),出院后继续口服上游抗心律失常药物12个月以上。根据体质指数(BMI)将患者分为超重和肥胖组68例,非超重和肥胖组54例,比较两组患者的临床特征及房颤复发率。结果所有患者共随访(14.9±3.0)个月,失访6例,失访率为4.9%。超重和肥胖组患者的BMI、24 h尿清蛋白定量、左心房内径、左心室舒张期末内径均大于非超重和肥胖组(P<0.05),高血压、糖尿病发生率均高于非超重和肥胖组(P<0.05)。超重和肥胖组房颤复发率为47.1%(32/68),非超重和肥胖组的18.5%(10/54),两组房颤复发率曲线比较,差异有统计学意义(log-rankχ2=64.106,P=0.003)。结论超重和肥胖是上游治疗的老年阵发性房颤患者房颤复发的影响因素,其作用机制可能是多方面的。Objective To investigate the impact of overweight and obesity on recurrence of paroxysmal atrial fibrilla- tion （AF） in elderly receiving upstream therapy. Methods A total of 122 patients （ aged 60 - 80 years） with AF treated in our hospital between July 2010 and January 2012 were included in our study. After discharged from the hospital, all of them con- tinued to take upstream antiarrhythmie drugs including fosinopril sodium, aldactone, atorvastatin, or bisoprolol over 12 months. Based on the body mass index （BMI） , the patients were divided into the overweight and obesity group （n = 68 ） and the normal weight group （ n = 54）. The clinical features and the AF recurrence rates were collected and compared between the two groups. Results The mean duration of follow - up was （ 14. 9 ± 3.0） months, and the lost - to - follow - up rate was 4. 9% （6/128）. The incidence of AF recurrence was significantly higher in the overweight and obesity group [47. 1% （32/68） ] than in normal weight group [ 18.5 % （10/54） ] （ log - rank X2 = 64. 106, P = 0. 003 ）. The BMI, the amount of 24 - hour urinary albumin, the left atrial diameter, the left ventrieular diastolic diameter, and the incidences of hypertension and diabetes were all signifi- cantly higher in the overweight and obesity group than those in the normal weight group （ P 〈 0. 05 ）. Conclusion Overweight and obesity have certain impact on the recurrence of AF in elderly receiving upstream therapy, and its mechanisms are rather complicated.

关 键 词：超重 肥胖症 老年人 心房纤颤 复发 

分 类 号：R541.75[医药卫生—心血管疾病] R589.25[医药卫生—内科学]