慢性心力衰竭患者合并心房颤动的危险因素分析  

Risk Factor Analysis in Patients With Chronic Heart Failure Combining Atrial Fibrillation

作　　者：黄学斌[1] 任小鹏[1] 解园星[1] 孙春喜[1] 李青[1] 

机构地区：[1]商洛市中心医院心内二科,陕西省726000

出　　处：《中国循环杂志》2015年第9期863-866,共4页Chinese Circulation Journal

摘　　要：目的：探索慢性心力衰竭患者合并心房颤动的危险因素及心房颤动复律后再发的预测因子。方法：纳入我院诊断的慢性心力衰竭合并初发心房颤动的患者71例（心房颤动组）及慢性心力衰竭未合并心房颤动的患者175例（非心房颤动组），统计其基线资料。以Logistic回归筛查心房颤动的危险因素。对复律成功的66例心房颤动患者行18个月随访，以Cox回归筛查心房颤动复律后复发的预测因子。结果：基线资料分析显示：心房颤动组年龄、病程、B型利钠肽、左心房内径、尿酸、肌酐明显大于非心房颤动组（P均〈0．05）。Logistic回归显示年龄（相对危险性1．89，95％可信区间1．08～3．31，P〈0．05）、病程（相对危险眭1．35，95％可信区间1．05～1．74，P〈0．05）、B型利钠肽（相对危险性1．82，95％可信区间1．30～2．53，P〈0．01）、左心房内径（相对危险性1．51，95％可信区间1．09～2．08，P〈0．05）为心房颤动的危险因素。Cox回归显示B型利钠肽（相对危险性1．30，95％可信区间1．09～1．54，P〈0．01）、左心房内径（相对危险性1．74，95％可信区间1．30-2．34，P〈0．01）为心房颤动复发的预测因子。结论：高龄、长病程、B型利钠肽水平增高、左心房内径增大是心力衰竭合并心房颤动的危险因素，而B型利钠肽水平增高、左心房内径增大是心房颤动复律后复发的客观预测指标。Objective： To explore the risk factors in patients with chronic heart failure （CHF） combining atrial fibrillation （AF） and to identify the predictive factors for AF recurrence after cardio version. Methods： A total of 246 CHF patients treated in our hospital were divided into 2 groups： CHF＋AF （AF） group, n=71 and CHF without AF （Non-AF） group, n=175. The baseline information was recorded. The risk factors for AF occurrence were screened by Logistic regression analysis. There were 66 AF patients with successful cardio verse and they were followed-up for 18 months, the predictors for AF recurrence were studied by Cox regression analysis. Results： The baseline information showed that age, CHF duration, left atria diameter （LAD）, the levels of BNP, uric acid and serum creatinine in AF group were all higher than those in Non-AF group, all P〈0.05. Logistic regression analysis presented that age （RR=1.89, 95% CI 1.08-3.31, P〈0.05）, CHF duration （RR=1.35, 95% CI 1.05-1.74, P〈0.05）, BNP level （RR=l.82, 95% CI 1.30-2.53, P〈0.01）, LAD （RR=1.51, 95% CI 1.09-2.08, P〈0.05） were the risk factors for AF occurrence. Cox regression analysis indicated that BNP level （RR=1.30, 95% CI 1.09-1.54, P〈0.01） and LAD （RR=l.74, 95% CI 1.30-2.34, P〈0.01 ） were the predictors for AF recurrence. Conclusion： The elder age, longer CHF duration, increased BNP level and LAD were the risk factors for AF occurrence in CHF patients. The increased BNP level and LAD were the objective predictors for AF recurrence after cardio version.

关 键 词：心力衰竭 心房颤动 B型利钠肽 左心房内径 LOGISTIC回归 COX回归 

分 类 号：R54[医药卫生—心血管疾病]