主动脉瓣置换术后新发持续性心房颤动的术前因素预判分析  

Preoperative risk factors prediction of new-onset persistent atrial fibrillation(PeAF)after aortic valve replacement

作　　者：徐琛 王颖骅 蒋莉[1] 叶静 刘晓芯[1] 沈文军[1] Xu Chen;Wang Yinghua;Jiang Li;Ye Jing;Liu Xiaoxin;Shen Wenjun(Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;不详)

机构地区：[1]上海市胸科医院-上海交通大学附属胸科医院,上海200030

出　　处：《中国循证心血管医学杂志》2020年第11期1357-1360,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：上海市教委护理高原学科建设项目(hlgy1910qnhb);上海市胸科医院科技发展基金课题(2019YJHL13)。

摘　　要：目的探讨主动脉瓣置换术(AVR)后新发持续性心房颤动(PeAF)的术前相关因素。方法回顾性分析将2015至2018年于上海交通大学附属胸科医院进行AVR的316例患者,根据术后是否发生持续性房颤分为PeAF组(109例)和非PeAF组(207例),通过对比两组患者基线资料、彩超检查资料及炎性因子,采用多因素Logistic回归探求分析影响AVR术前发生PeAF的危险因素。结果PeAF组患者的年龄(P<0.001)和术前左房容积(P<0.001)大于非PeAF组,且其术前基质金属蛋白酶-2(MMP-2,P<0.001)、N末端脑钠肽前体(NT-proBNP,P<0.001)水平明显高于非PeAF组,差异皆有统计学意义。多因素Logistic回归分析显示,年龄≥60岁(OR=1.754,95%CI:1.022~2.979,P<0.05)、左房容积(OR=1.066,95%CI:1.039~1.094,P<0.01)、NT-proBNP(OR=1.004,95%CI:1.002~1.007,P<0.01)、MMP-2(OR=1.028,95%CI:1.014~1.043,P<0.01)水平升高是AVR术后新发PeAF的独立危险因素。结论高龄、心房容积较大、术前NT Pro-BNP及MMP-2水平较高者AVR后更易新发PeAF。Objective To discuss the predictive preoperative factors of new-onset persistent atrial fibrillation(PeAF)after aortic valve replacement(AVR).Methods The patients(n=316)undergone AVR from Shanghai Chest Hospital affiliated to Shanghai Jiao Tong University were retrospectively analyzed from 2015 to 2018.All patients were divided,according to PeAF occurrence,into PeAF group(n=109)and non-PeAF group(n=207).The baseline data,materials of color ultrasound examination and inflammatory factors were compared between 2 groups.The preoperative risk factors of PeAF after AVR were analyzed by applying multi-factor Logistic regression analysis.Results Age(P<0.001)and preoperative left atrial volume(P<0.001)were higher in PeAF group than those in non-PeAF group,and MMP-2(P<0.001)and NT-proBNP(P<0.001)were significantly higher in PeAF group than those in non-PeAF group.The multi-factor Logistic regression analysis showed that age≥60(OR=1.754,95%CI:1.022~2.979,P<0.05),left atrial volume(OR=1.066,95%CI:1.039~1.094,P<0.01),and increased NTproBNP(OR=1.004,95%CI:1.002~1.007,P<0.01)and MMP-2(OR=1.028,95%CI:1.014~1.043,P<0.01)were independent risk factors of PeAF after AVR.Conclusion The patients with advanced age,increased atrial volume and higher preoperative levels of NT Pro-BNP and MMP-2 will much easily suffer from PeAF after AVR.

关 键 词：主动脉瓣置换术 术后 持续性房颤 危险因素 

分 类 号：R541.71[医药卫生—心血管疾病]