体质指数与心房颤动患者预后的关系  

Relationship between body mass index and prognosis in patients with atrial fibrillation

作　　者：阿迪莱·阿卜杜力克木 刘帅[1] 韩敏 于子翔[2] 马依彤[2] Adilai Abudulikemu;LIU Shuai;HAN Min;YU Zixiang;MA Yitong(The First Clinical Medical College and the First Affiliated Hospital,Urumqi 830054,China;Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一临床医学院暨第一附属医院,乌鲁木齐830054 [2]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054

出　　处：《新疆医科大学学报》2020年第2期135-139,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(91957208)

摘　　要：目的探讨心房颤动(AF)患者体质指数(BMI)对主要不良心血管事件(MACE)及全因死亡的预测作用。方法纳入2015年6月-2019年6月就诊于新疆医科大学第一附属医院的心房颤动患者460例,其中男性305例,女性155例,年龄30~98岁。依据BMI水平,使用四分位法将入选对象分为Q1组(BMI≤23.33 kg/m^2,84例)、Q2组(23.33 kg/m^228.07 kg/m^2,82例)。收集入选者临床基线资料,用酶法检测血清总胆固醇,甘油三酯以及心脏超声测量左房大小及射血分数。记录MACE和全因死亡情况。采用Cox比例风险回归分析及ROC曲线评估BMI对AF患者预后的预测价值。结果4组中,冠心病、高血压、脑血管病比较,差异有统计学意义(P<0.05)。BMI预测房颤预后的ROC曲线下面积(AUC)为0.442(95%CI:0.368~0.516),ROC曲线下面积<0.5,预测价值低。随访期间,发生MACE 251例(76.5%),死亡6例(1.8%),Q1、Q2、Q3、Q4组患者MACE发生率无明显差异(P>0.05)。结论在本院心房颤动患者中,BMI对房颤患者MACE及全因死亡预测价值低。体质指数介于23.33~26.23 kg/m^2的房颤患者,其生存时间可能较其余BMI水平的患者长。Objective To study the role of Body Mass Index(BMI)in predicting Major Adverse Cardiovascular Events(MACE)and all-cause mortality occurred in the Atrial Fibrillation(AF)patients.Methods A total of 460 patients with AF who visited the First Affiliated Hospital of Xinjiang Medical University from 2015 to 2019 were included,of 305 males and 155 females,aged between 30 and 98.According to BMI,they were divided into Q1 group(BMI≤23.33 kg/m^2,84 cases),Q2 group(23.33 kg/m^2<BMI≤26.23 kg/m^2,81 cases),Q3 group(26.23 kg/m^2<BMI≤28.07 kg/m^2,81 cases)and Q4 group(BMI>28.07 kg/m^2,82 cases).The clinical baseline data of them were collected.Serum total cholesterol,triglyceride and left atrial size and ejection fraction were measured by enzyme method and echocardiography.MACE and all-cause deaths were recorded.Cox proportional risk regression analysis and ROC curve were used to evaluate the prognostic value of BMI in patients with AF.Results There were significant differences in coronary heart disease,hypertension and cerebrovascular disease among the four groups(P<0.05).The area under the ROC curve for predicting the prognosis of AF was 0.442(95%CI:0.368-0.516),and the area under the ROC curve was less than 0.5,and the predictive value was low.During follow-up,251(76.5%)MACE occurred and 6(1.8%)deaths.There was no significant difference in the incidence of MACE between Q1,Q2,Q3 and Q4 groups(P>0.05).Conclusion BMI has low predictive value for mace and all-cause death in patients with atrial fibrillation.The survival time of AF patients with body mass index between 23.33-26.23 kg/m^2 may be longer than that of other BMI patients.

关 键 词：体质指数 心房颤动 主要不良心血管事件 全因死亡 

分 类 号：R541.75[医药卫生—心血管疾病]