急性心肌梗死后的新发心房颤动及相关因素分析  

Clinical analysis of acute myocardial infarction patients with new-onset atrial fibrillation

作　　者：熊丹群[1] 陈治松[1] 徐文俊[1] 

机构地区：[1]上海市同济医院心血管内科,上海200065

出　　处：《中国心脏起搏与心电生理杂志》2016年第2期120-122,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：上海市科委引导类项目(编号:124119a000)

摘　　要：目的探讨影响急性心肌梗死（AMI）后新发心房颤动（简称房颤）的危险因素。方法收集2013年2月至2014年10月间心内科住院首次诊断为AMI患者共376例，根据心律情况分为窦性心律（简称窦律）组和房颤组。对其临床特征进行对比，并进行Logistic多因素回归分析。结果376例AMI患者中，新发房颤46例，与窦律组比较，房颤组年龄更大，脑利钠肽前体、高敏c反应蛋白（hsCRP）、肌钙蛋白峰值、TIMI评分、Killip分级更高，Logistic多因素回归分析显示：hs—CRP（OR值：3．429、95％CI：1．384～8．496、P=0．008）、肌钙蛋白峰值（OR值：1．014、95％CI：1．003～1．024、P=0．010）和TIMI评分（OR值：1．251、95％CI：1．020～1．534、P=0．031）与新发房颤相关。结论hs—CRP、肌钙蛋白峰值、TIMI评分为影响AMI后新发房颤的独立危险因素。Objective To explore the risk factors of new-onset atrial fibrillation（AF）among patients with acute myocardial infarction（AMI）. Method From February 2013 to December 2014,a total of 376 patients with first- ever AMI admitted to the Tongji Hospital of Tongji University were selected. According to the incidence of AF,the subjects were divided into sinus rhythm group and new onset AF group. Its clinical features were compared. Logis- tic regression analyses of multiple factors were performed to evaluate the risk factors of new-onset AF among AMI patients. Result A total of 376 cases were diagnosed as AMI,of whom 46 cases of new onset AF were observed. patients with new-onset AF were older, higher killip class and TIMI scores, higher levels of proBNP,hs-CRP and the peak of cardiac troponinIc（TnI）,Logistic regression analysis showed that the odds ratio of hs-CRP, the peak of cardiac TnI and TIMI risk score were 3. 429,1. 014 and 1. 251, respectively（95 % CI ： 1. 384 -8. 496, P= 0. 008,1. 003-1.024,P=0.010 and 1.020-1.534,P=0.031）. Conclusion hs-CRP,the peak of cardiac troponinIc and TIMI risk score are the risk factors for new-onset atrial fibrillation after AMI. [Chinese Journal of Cardiac Pacing and Electrophysiology, 2016,30 （2） ： 120-- 122]

关 键 词：心血管病学 急性心肌梗死 心房颤动 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病] R541.75[医药卫生—内科学]