心血管健康评分与新发心房颤动的关系  

Association between the cardiovascular health score and new-onset atrial fibrillation

作　　者：施继红[1] 邢爱君[1] 王永芝[1] 季春鹏[1] 朱辰蕊[1] 魏晓明[1] 吴寿岭[1] 

机构地区：[1]开滦总医院心内科,唐山063000

出　　处：《中华心血管病杂志》2016年第8期714-720,共7页Chinese Journal of Cardiology

摘　　要：目的探讨心血管健康评分与新发心房颤动的关系。方法将参加2006年7月至2007年10月开滦集团公司健康体检且无心房颤动病史的职工95 026名作为观察队列，2008年7月至2009年10月、2010年7月至2011年10月和2012年7月至2013年10月分别对观察队列进行第2、3和4次健康体检，排除新发瓣膜病性心房颤动者以及参数缺失者后，最终纳入分析的研究对象共85 028名。根据美国心脏协会定义的理想心血管健康行为和因素以及心血管健康评分体系对研究对象进行评分，按基线心血管健康评分结果将研究人群分为4组，即0～6分组（11 103名）、7～8分组（24 487名）、9～10分组（32 556名）和11～14分组（16 882名）。观察各组心房颤动的发病率，并采用多因素Cox回归分析不同心血管健康评分与新发心房颤动的关系。结果随访（5.6±1.4）年后，共有254例研究对象发生心房颤动，发病率为0.53/千人年。0～6分组、7～8分组、9～10分组和11～14分组心房颤动的发病率分别为0.69/千人年、0.60/千人年、0.56/千人年和0.30/千人年（P〈0.01）。多因素Cox回归分析显示，校正年龄、性别、文化程度、收入水平、饮酒、心肌梗死病史、卒中病史、血清尿酸和C反应蛋白后，心血管健康评分每增加1分，心房颤动的发病风险降低8%（HR＝0.92，95%CI 0.86～0.99，P〈0.05）；与0～6分组相比，11～14分组发生心房颤动的风险降低49%（HR＝0.51，95%CI 0.31～0.83，P〈0.01）。结论心血管健康评分越高，发生新发心房颤动的风险就越低。临床试验注册号中国临床试验注册中心，注册号为ChiCTR-TNRC-11001489。Objective To observe the association between the cardiovascular health score and new- onset atrial fibrillation. Methods A total of 95 026 participants who participated the health examination between July 2006 and October 2007 at Kailuan group and without history of atrial fibrillation were selected as the observation cohort. The second, the third and the fourth health examination were performed between July 2008 to October 2009, July 2010 to October 2011, July 2012 to October 2013, respectively. A total of 85 028 participants were included in the final analysis after excluding participants who had new-onset valvular atrial fibrillation and participants lost to follow-up. The participants were divided into 4 subgroups by cardiovascular health score at basefine according to the definition of AHA and cardiovascular heahh scoring system, namely group of 0 -6 points （n = 11 103） , 7 -8 points （n =24 487）, 9 - 10 points （n = 32 556）, and 11 -14 points （n = 16 882）. The incidence of atrial fibrillation in each subgroup was observed, and the association between cardiovascular health score and risk of new-onset atrial fibrillation was analyzed using multiple Cox regression analysis. Results A total of 254 participants developed atrial fibrillation during the median of （ 5.6 ± 1.4 ） years follow-up. The total incidence of new-onset atrial fibrillation was 0. 53/1 000 person-year. The incidence of atrial fibrillation was 0. 69/1 000 person-year, 0. 60/1 000 person-year, 0. 56/1 000 person-year, and 0. 30/1 000 person-year, respectively in 0 - 6 points, 7- 8 points, 9- 10 points, and 11 -14 points subgroups, respectively （P 〈 0.01 ）. After adjustment of age, gender, education level, income, drink, history of myocardial infarction, history of stroke, serum uric acid and C reactive protein level, multiple Cox regression analysis showed that one health score point increase was related to 8% reduction of new onset atrial fibrillation（ FIR = 0. 92,95% CI O. 86 - 0. 99, P 〈 0. 05 ）. Compared with

关 键 词：健康行为 心房颤动 发病率 

分 类 号：R541.75[医药卫生—心血管疾病]