不停跳冠状动脉旁路移植术后发生房颤的影响因素  

Influencing factors of atrial fibrillation after off-pump coronary artery bypass grafting

作　　者：蒲振业[1] 李鸿雁[1] 何伟[1] 刘志勇[1] PU Zhen-ye;LI Hong-yan;HE Wei;LIU Zhi-yong(Department of Cardiothoracic Surgery,Zhongda Hospital Southeast University,Nanjing,Jiangsu 210009,China)

机构地区：[1]东南大学附属中大医院胸心外科,江苏南京210009

出　　处：《中国临床研究》2022年第8期1055-1058,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨不停跳冠脉搭桥术患者发生术后房颤的危险因素以及可能的预测指标。方法回顾性分析东南大学附属中大医院2018年1月至2020年6月接受不停跳冠脉搭桥手术患者126例患者的临床资料,根据术后是否发生房颤分为房颤组(28例)和对照组(98例)。对两组患者的临床数据资料进行分析,对患者术后发生术后房颤的危险因素进行二元logistic回归分析。结果两组年龄、手术时间、输血量、左心房内径(LA)、左室射血分数(LVEF)、高血压病史、术前CRP和术前术后肌钙蛋白(TNI)、B型利钠肽(BNP)差异有统计学意义(P<0.05)。Logistic回归分析显示,高龄(OR=1.126)、LA增大(OR=1.975)、术前高BNP(OR=1.841)、术前高CRP(OR=1.861)和高血压病史(OR=2.911)为冠脉搭桥患者术后发生房颤的危险因素(P<0.05)。结论高龄、有高血压病史、LA增大、术前高BNP、术前高CRP水平会增加不停跳冠脉搭桥术患者发生术后房颤的风险,应采取相应预防措施对高危人群进行有效干预。Objective To investigate the risk factors and possible predictors of postoperative atrial fibrillation(POAF)in patients received off-pump coronary artery bypass grafting(OPCABG).Methods The clinical data of 126 patients received OPCABG in Zhongda Hospital Southeast University from January 2018 to June 2020 were collected and analyzed retrospectively.There were 28 patients in POAF group and 98 patients in control group(without POAF).The binary logistic regression was used to analyze the risk factors of postoperative atrial fibrillation.Results There were significant differences in age,operation time,intraoperative blood transfusion,left atrial diameter(LA),left ventricular ejection fraction(LVEF),history of hypertension,preoperative CRP,preoperative and postoperative troponin and B-type natriuretic peptide(BNP)levels between two groups(P<0.05).Logistic regression analysis showed that older age(OR=1.126),increased LA(OR=1.975),preoperative higher levels of BNP(OR=1.841)and CRP(OR=1.861)and history of hypertension(OR=2.911)were the risk factors for postoperative atrial fibrillation in patients with coronary artery bypass grafting(P<0.05).Conclusion For the patients undergoing OPCABG,the risk of POAF may be higher in the patients with advanced age,history of hypertension,increased LA and preoperative high BNP and CRP levels,and corresponding preventive measures should be taken effectively.

关 键 词：不停跳冠脉搭桥术 房颤 高血压 左心房内径 B型利钠肽 

分 类 号：R654.2[医药卫生—外科学]