肾小球滤过率对老年心房颤动患者血栓栓塞的影响  

Effect of Glomerular Filtration Rate on Thromboembolism in Elderly Patients with Atrial Fibrillation

作　　者：梁晗[1] 杨娜[1] 肖婷[1] LIANG Han;YANG Na;XIAO Ting(Department of Cardiology,Shangluo Central Hospital,Shangluo,260000,China)

机构地区：[1]商洛市中心医院心血管内科,商洛260000

出　　处：《血栓与止血学》2021年第5期728-731,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的分析肾小球滤过率(eGFR)对老年心房颤动患者血栓栓塞的影响。方法选择2017年10月至2020年10月经我院收治并进行治疗的148例心房颤动老年患者作为本次研究对象,并根据2002年K/DOQI指南将研究对象的肌酐按照CKD-EPI评估公式计算出eGFR,并将估算结果分组随访期间血栓栓塞事件发生情况,同时采用多因素分析eGFR与老年心房颤动患者血栓栓塞的关系。结果eGFR≥60 ml/(min·1.73 m^(2))组老年心房颤动患者血栓栓塞事件发生率均明显低于eGFR45~59 ml/(min·1.73 m^(2))组、eGFR<45 ml/(min·1.73 m^(2))组(5.71%vs 15.22%vs 31.25%,P<0.05)。eGFR<45 ml/(min·1.73 m^(2))组患者糖尿病发生率、既往脑卒中史发生率、冠心病发生率、高血压发生率、血清肌酐水平、尿蛋白发生率均明显高于eGFR≥60 ml/(min·1.73 m^(2))组、eGFR45~59 ml/(min·1.73 m^(2))组,LVEF明显低于eGFR≥60 ml/(min·1.73 m^(2))组、eGFR45~59 ml/(min·1.73 m^(2))组(P<0.05)。经Logistic多因素回归分析结果显示:eGFR、尿蛋白均能够作为影响老年心房颤动患者发生血栓栓塞的独立危险因素。结论eGFR水平下降的老年心房颤动患者血栓栓塞发生率高,因此eGFR水平变化能够作为预测老年心房颤动患者血栓栓塞的独立危险因素。Objective To analyze the effect of cytofiltration rate(eGFR)on thromboembolism in elderly atrial fibrillation patients.Methods The 148 elderly patients with atrial fibrillation who were treated and treated by our hospital from October 2017 to October 2020 were selected for this study and will be treated according to K/DOQI guidelines for 2002 The creatinine of the study subjects calculated eGFR according to the CKD-EPI evaluation formula,and grouped the estimated results to analyze the relationship between eGFR and thromboembolism in elderly atrial fibrillation patients using multiple factors.Results EGFR≥60 ml/(min.1.73 m^(2))group of elderly atrial fibrillation patients with thrombotic embolism event rate was significantly lower than eGFR45 to 59 ml/(min.1.73 m^(2))group,eGFR<45 ml/(min.1.73 m^(2))group(5.71%vs 15.22%vs 31.25%,P<0.05).The incidence of<diabetes,past stroke history,coronary heart disease,hypertension,serum creatinine level and urinary protein were significantly higher than eGFR≥60 ml/(min.1.73 m^(2))group,eGFR 45 to 59 ml/(min.1.73 m^(2))group,LVEF significantly lower than eGFR≥60 ml/(min.73 m^(2))group,eGFR45 to 59 ml/(min.1.73 m^(2))group(P<0.05).The results of Logistic multi-factor regression analysis showed that eGFR and urine protein could be used as independent risk factors to affect thromboembolism in elderly patients with atrial fibrillation.Conclusion The risk of thromboembolism was high in elderly atrial fibrillation patients with decreased eGFR levels,so changes in eGFR levels could be used as an independent risk factor for predicting thrombosis in elderly atrial fibrillation patients.

关 键 词：肾小球滤过率 心房颤动 血栓栓塞 

分 类 号：R541.75[医药卫生—心血管疾病]