非瓣膜性阵发性及持续性心房颤动术后复发的危险因素研究  

Risk factors for postoperative recurrence of nonvalvular paroxysmal and persistent atrial fibrillation

作　　者：张渊[1] 林中园[1] 冯莉[1] 吉亚军[1] Zhang Yuan;Lin Zhongyuan;Feng Li;Ji Yajun(Department of Cardiology,Haining People's Hospital,Haining 314400,Zhejiang Province,China)

机构地区：[1]海宁市人民医院心内科,海宁314400

出　　处：《中国基层医药》2023年第6期876-880,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省海宁市科技计划(2021038)。

摘　　要：目的分析非瓣膜性阵发性及持续性心房颤动术后复发的危险因素。方法选取海宁市人民医院2019年10月至2021年10月收治的行射频消融手术(radiofrequency ablation,RFA)的非瓣膜性阵发性、持续性心房颤动患者100例为观察对象,对所有患者进行为期1年的随访,将术后心房颤动复发的30例患者设为观察组,将术后心房颤动未复发的70例患者设为对照组,单因素、多因素logistic回归分析RFA后心房颤动复发的危险因素。结果logistic回归分析,年龄、体质量指数(body mass index,BMI)、糖尿病、高血压、风湿性心脏病、左心房前后径(anteroposterior diameter of left atrium,LAD)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、脑钠肽(brainnatriureticpeptide,BNP)是RFA后心房颤动复发的危险因素(均P<0.05)(OR=1.31、1.33、1.32、1.34、1.26、1.24、1.36、1.33,95%CI为1.028~1.442、1.031~1.427、1.042~1.434、1.124~1.452、1.013~1.385、1.005~1.326、1.039~1.482、1.064~1.478)。结论非瓣膜性阵发性、持续性心房颤动患者RFA后心房颤动复发与多种因素有关,临床应针对以上危险因素,及早给予针对性处理,尽可能降低心房颤动复发率,改善患者预后。Objective To analyze the risk factors of postoperative recurrence of nonvalvular paroxysmal and persistent atrial fibrillation.Methods A total of 100 patients who received treatment in Haining People's Hospital from October 2019 to October 2021 were included in this study.All patients were followed up for 1 year.Thirty patients with postoperative recurrence of atrial fibrillation were included in the observation group,and seventy patients without postoperative recurrence of atrial fibrillation were included in the control group.Univariate and multivariate logistic regression analyses were performed to analyze the risk factors of postoperative recurrence of atrial fibrillation after radiofrequency ablation.Results Logistic regression analysis results revealed that age,body mass index,diabetes mellitus,hypertension,rheumatic heart disease,anteroposterior diameter of the left atrium,glycosylated hemoglobin,brain natriuretic peptide are the risk factors of recurrent atrial fibrillation after radiofrequency ablation(all P<0.05)(OR=1.31,1.33,1.32,1.34,1.26,1.24,1.36,1.33;95%CI=1.028-1.442,1.031-1.427,1.042-1.434,1.124-1.452,1.013-1.385,1.005-1.326,1.039-1.482,1.064-1.478).Conclusion The recurrence of nonvalvular paroxysmal and persistent atrial fibrillation after radiofrequency ablation is related to many factors.The risk factors should be taken into account in clinical practice,and targeted treatment should be given as early as possible to reduce the recurrence rate of atrial fibrillation and improve prognosis.

关 键 词：心房颤动 导管消融术 复发 危险因素 糖尿病 高血压 血红蛋白 糖基化 利钠肽 脑 

分 类 号：R654.2[医药卫生—外科学]