心房颤动射频消融术后血栓栓塞事件的危险因素研究  

Risk factors of thromboembolism after radiofrequency ablation of atrial fibrillation

作　　者：贾静[1] 付微 唐山丹 蒋慧[1] 胡轶 黄宇霞[3] Jia Jing;Fu Wei;Tang Shandan(Cardiovascular Medicine,Liuzhou People's Hospital,Liuzhou 545006,China)

机构地区：[1]柳州市人民医院心血管内科,545006 [2]柳州市人民医院门诊部,545006 [3]柳州市人民医院儿科,545006

出　　处：《中华保健医学杂志》2021年第6期580-582,共3页Chinese Journal of Health Care and Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210420)。

摘　　要：目的研究心房颤动射频消融术后血栓栓塞事件的危险因素。方法回顾性分析柳州市人民医院2018年1月~2021年1月390例经射频消融术治疗的心房颤动患者临床资料,依据患者术后2个月内血栓栓塞事件发生情况分为血栓栓塞组(26例)、无血栓栓塞组(364例)。收集两组患者基础资料信息包括年龄、性别、体质量指数、吸烟、饮酒、原发性高血压、糖尿病、病程、左室射血分数及红细胞计数(RBC)、血红蛋白(Hb)、总胆固醇(TC)、三酰甘油(TG)、血管性假性血友病因子(vWF)、纤维蛋白原(FIB)、D-二聚体(D-D)。对比两组基础资料信息差异,并采用多因素logistic回归分析法分析心房颤动患者射频消融术后发生血栓栓塞事件的影响因素。结果两组患者年龄、性别、体重指数、吸烟、饮酒、糖尿病、病程、左室射血分数及RBC、Hb、TG、TC、FIB水平对比差异均无统计学意义(P>0.05);血栓栓塞组原发性高血压及房颤复发患者占比显著高于无血栓栓塞组,左房内径及vWF、D-D水平均显著高于无血栓栓塞组,差异有统计学意义(P<0.05)。经多因素logistic分析显示,原发性高血压(OR=1.407,95%CI=1.017~1.947)、vWF(OR=1.513,95%CI=1.146~1.998)、D-D(OR=1.650,95%CI=1.246~2.185)是心房颤动患者射频消融术后发生血栓栓塞事件的独立影响因素(P<0.05)。结论原发性高血压、左房内径、房颤复发、vWF、D-D是心房颤动患者射频消融术后发生血栓栓塞事件的独立影响因素,临床应引起重视。Objective To study the risk factors of thromboembolism after RFA.Methods the clinical data of 390 patients with atrial fibrillation treated by radiofrequency ablation in our hospital from January 2018 to January 2021 were retrospectively analyzed.According to the occurrence of thromboembolic events within 2 months after operation,the patients were divided into thromboembolic group(n=26)and non thromboembolic group(n=364).The basic information(age,gender,body mass index,smoking,drinking,essential hypertension,diabetes,course of disease,left ventricular ejection fraction,red blood cell count(RBC),hemoglobin(HB),total cholesterol(TC),triglyceride(TG),von Willebrand factor(vWF)of the two groups were collected Fibrinogen(FIB),D-Dimer(D-D)].The differences of basic information between the two groups were compared,and the influencing factors of thromboembolic events in patients with atrial fibrillation after radiofrequency ablation were analyzed by multivariate logistic regression analysis.Results There was no significant difference in age,gender,body mass index,smoking,drinking,diabetes,course of disease,left ventricular ejection fraction,RBC,Hb,TG,TC and FIB levels between the two groups(P>0.05);The proportion of patients with primary hypertension and recurrence of atrial fibrillation in thromboembolism group was significantly higher than that in non thromboembolism group,and the left atrial diameter,vWF and D-D water in thromboembolism group were significantly higher than those in non thromboembolism group(P<0.05).Multivariate logistic analysis showed that,essential hypertension(OR=1.407,95%CI=1.017~1.947),vWF(OR=1.513,95%CI=1.146~1.998),D-D(OR=1.650,95%CI=1.246~2.185)were independent influencing factor of thromboembolism after radiofrequency ablation in patients with atrial fibrillation(P<0.05).Conclusion Essential hypertension,left atrial diameter,recurrence of atrial fibrillation,vWF and D-D are the independent influencing factors of thromboembolic events in patients with atrial fibrillation after radiofrequency a

关 键 词：心房颤动 射频消融术 血栓栓塞 危险因素 血管性假性血友病因子 

分 类 号：R543[医药卫生—心血管疾病]