血清胆红素与高血压合并心房颤动及其危险因素的相关性  

The Relationship between Serum Bilirubin and Atrial Fibrillation in Patients with Hypertension

作　　者：朱玉果 周洲[2] 刘子铭[2] 曾宪涛[2] 童传凤[2] Zhu Yuguo;Zhou Zhou;Liu Ziming(Department of Cardiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]南阳医学高等专科学校第一附属医院冠心病监护病房,河南南阳473000 [2]武汉大学中南医院心血管内科,湖北武汉430071

出　　处：《医学新知》2018年第5期484-487,492,共5页New Medicine

基　　金：湖北省卫生计生委科研项目面上项目(编号WJ2017M040)。

摘　　要：目的 探讨血清胆红素与高血压合并心房颤动(AF)及其危险因素的相关性.方法 将460例高血压患者依据心电图分为AF组(226例)和非AF组(234例).对血清胆红素和业已共识的传统危险因素进行检测,并比较之间的相关性.结果 AF组年龄及左心房内径(LAD)比非AF组大(P=0.000),血清总胆红素(TBIL)、直接胆红素(DBIL)、高敏C反应蛋白(hs-CRP)、红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞比值(NLR)、血尿酸(UA)、胱抑素(cysC)、血肌酐(CREA)及D-二聚体较非AF组高,血甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆固醇(TC)及左心室射血分数(LVEF)较非AF组低,糖尿病与AF发生相关;多因素logistic回归分析显示年龄(OR=1.115,Walds=41.120)和LAD(OR=1.220, Walds=28.710)是 AF发生的独立危险因素;TBIL(OR=1.078,Walds=4.321,P=0.038)和 DBIL(OR =0.827,Walds=4.468,P=0.035)及TC(OR=0.207,Walds =11.471,P=0.001)也与房颤发生密切相关.结论 血清胆红素含量高、胆固醇水平低、高龄及左房内径增大者发生AF的危险性越大.Objective To investigate the relationship between serum bilirubin and atrial fibrillation (AF)in patients with hypertension.Methods 460patients with hypertension diagnosed as AF by electrocardiograph(ECG)were divided into AF group (n =226)and non -AF group(n =234).Serum bilirubin and other risk factors were detected and compared.Results The age of patients in AF group was older and left atrial diameter (LAD)was larger than that in non-AF group (P =0.000),with higher levels of serum level of total bilirubin (TBIL),direct bilirubin (DBIL), high sensitive C -reactive protein concentrations(hs -CRP),red blood cell distribution width(RDW),neutrophil/ lymphocyte ratio (NLR),uric acid (UA),cystatinC (cysC),serum creatinine (CREA),D -dimmer and lower levels of triglycerides (TG),low-density lipoprotein(LDL),high-density lipoprotein(HDL),total cholesterol (TC),left ven- tricular ejection fraction(LVEF).The history of diabetes was related to AF.Multivariate logistic regression analysis showed that age(OR =1.115,Walds =41.120)and LAD (OR =1.220,Walds =28.710)were the significant inde- pendent risk factors of AF.TBIL(OR =1.078,Walds =4.321,P =0.038),DBIL(OR =0.827,Walds =4.468,P = 0.035)and TC(OR =0.207,Walds =11.471,P =0.001)were related with AF.Conclusions High level of serum bilirubin concentration,low level of TC,advanced age and high level of LAD will increase the risk of AF.

关 键 词：高血压 心房颤动 炎症因子 血清胆红素 相关危险因素 

分 类 号：R541.75[医药卫生—心血管疾病]