非体外循环冠状动脉旁路移植术后房颤与心脏结构功能的相关性研究  

Correlative study between cardiac structure and function of atrial fibrillation patients after offpump coronary artery bypass

作　　者：韩宏光[1] 王辉山[1] 金岩[1] 于岩[1] 赵洋[1] 李晓密[1] 曲虹[1] 

机构地区：[1]解放军沈阳军区总医院心外科,110016

出　　处：《中国临床实用医学》2016年第5期4-8,共5页China Clinical Practical Medicine

摘　　要：目的探讨非体外循环冠状动脉旁路移植术（OPCAB）术后房颤（AF）患者的心脏结构功能与房颤相关性。方法回顾性分析沈阳军区总医院心外科2012年1月至2014年12月行OPCAB治疗的患者的临床资料。选取术后房颤患者165例作为房颤组（AF组），选取年龄、性别、合并疾病相匹配的非心房颤动患者165例作为非房颤组（NAF组）。记录两组患者年龄、性别、合并疾病等基本情况及心脏彩超指标，并采用单因素分析和t检验比较两组各项指标的差异，对存在统计学差异的指标进行多因素logistic回归分析，得出预测OPCAB术后房颤的独立危险因素。采用受试者工作特征曲线（ROC）评价该独立危险因素的敏感性与有效性，根据Youden指数最大的切点确定最佳临界点。结果OPCAB术后两组患者一般情况差异无显著统计学意义。AF组患者左房内径、左室舒张末容积、合并二尖瓣关闭不全者大于NAF组，左室射血分数小于NAF组，差异有统计学意义（P〈0．05）。左房内径是OPCAB术后心房颤动的独立预测因素（P〈0．05）。结论OPCAB术后AF患者左房内径、左室收缩功能、左室舒张末容积、二尖瓣关闭不全是OPCAB术后房颤的危险因素，其中左房内径可能是OPCAB术后房颤发生的独立危险因素。Objective To investigate the relationship between cardiac structure and function of atrial fibrillation patients after off-pump coronary artery bypass. Methods The clinic data of patients after off-pump coronary artery bypass （OPCAB） was analyzed retrospectively in department of cardiavascular surgery of the general hospital of Shenyang military region from January 2012 to December 2014. The patients were divided into two groups, AF group and NAF group. The AF group included 165 patients with atrial fibrillation（AF）. The NAF group included 165 patients whose age, sex and previous medical history matched the AF group. Age, sex, previous medical history and echocardiography of all the patients were recorded. Two groups were compared with one-way analysis variance and test. The factors with statistical difference were analysed by multivariate logistic analysis to find out the independent risk factor of AF after OPCAB. The independent risk factors sensitivity and effectiveness were evaluated by the receiver operator characteristic curve （ROC）. The best critical point was made according to the ~ouden index biggest point of tangency. Results There were no significant differences in base situation between the two groups. The level of LAD, LVEDV and MI in AF group were significantly higher than that in NAF group, the LVEF was significantly decreased in AF group compared with the NAF group（P〈0.05）. LAD was the independent predictor for AF after OPCAB（P〈0.05）. Conclusions LAD, LVEF, LVEDV and MI were risk factors of AF following OPCAB.LAD was the independent risk factor of AF following OPCAB.

关 键 词：非体外循环冠状动脉旁路移植术 心脏结构 心房颤动 

分 类 号：R65[医药卫生—外科学]