二尖瓣及主动脉瓣置换术后心电图变化及心房颤动的影响因素  

Influencing factors of the changes of electrocardiogram and atrial fibrillation after mitral valve and aortic valve replacement

作　　者：房大广[1] 冯增斌[1] 崔春燕[1] 陈永良[1] FANG Da-guang;FENG Zeng-bin;CUI Chun-yan;CHEN Yong-liang(Department of Cardiac Surgery,The Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)

机构地区：[1]承德医学院附属医院心脏外科,河北承德067000

出　　处：《蚌埠医学院学报》2020年第12期1674-1676,1680,共4页Journal of Bengbu Medical College

摘　　要：目的:研究二尖瓣及主动脉瓣置换术后病人心电图变化及心房颤动(atrial fibrillation,AF)的影响因素。方法:选取行二尖瓣及主动脉瓣置换术病人130例作为研究对象,根据其术后是否发生AF进行分组,观察发生AF组与未发生AF组病人手术前后心电图变化情况,采用单因素与二元logistic回归分析导致发生AF的独立危险因素。结果:单因素与二元logistic回归分析结果显示:心功能分级、术前肺动脉收缩压、同期行其他手术、机械通气时间、术后发生肺炎、病人年龄、术后脑钠肽水平是导致病人发生AF的影响因素与独立危险因素(P<0.01)。AF组心电图指标中QRSd、QTc指标显著高于非AF组(P<0.01);QT指标显著低于非AF组(P<0.01)。AF组病人术后心电图QRS波振幅变化中、S1、S2、S3、R5、R6显著低于非AF组(P<0.01)。结论:二尖瓣及主动脉瓣置换术后病人发生AF病人与未发生AF病人心电图会发生显著变化,心功能分级、术前肺动脉收缩压、同期行其他手术、机械通气时间、术后发生肺炎、病人年龄、术后脑钠肽水平是导致病人发生AF独立危险因素。Objective:To study the influencing factors of the changes of electrocardiogram(ECG)and atrial fibrillation(AF)after mitral valve and aortic valve replacement.Methods:One hundred and thirty patients treated with mitral and aortic valve replacement were divided into two groups according to the occurrence of AF after operation.The changes of ECG before and after operation in two groups were observed,and the independent risk factors of AF were analyzed using univariate and binary logistic regression analysis.Results:The results of univariate and binary logistic regression analysis showed that the cardiac function grade,preoperative pulmonary systolic pressure,other operations at the same period,duration of mechanical ventilation,pneumonia after operation,age of patients,and BNP level after operation were the influencing factors and independent risk factors of AF(P<0.01).The electrocardiographic indexes QRSd and QTc in AF group were significantly higher than those in non-AF group(P<0.01),and the QT in AF group was significantly lower than that in non-AF group(P<0.01).After operation,the changes of the S1,S2,S3,R5 and R6 of QRS wave amplitude in AF group were significantly lower than those in non-AF group(P<0.01).Conclusions:There are significant changes in ECG in patients with and without AF after mitral valve and aortic valve replacement.The cardiac function grade,preoperative pulmonary artery systolic pressure,other operations at the same period,mechanical ventilation time,postoperative pneumonia,patient age and postoperative BNP level are the independent risk factors of AF.

关 键 词：心房颤动 双瓣置换术 心电图 

分 类 号：R541.75[医药卫生—心血管疾病]