中国北方人群心房颤动与新发慢性肾脏病发病风险的相关性研究  

Correlation between Atrial Fibrillation and the Risk of New-onset Chronic Kidney Disease in Northern Chinese Population

作　　者：张爱丽 侯旗旗 韩全乐 张伯亨 张佳伟 曹宏霞 张超 陈朔华[5] 吴寿岭[5] 李康博 ZHANG Aili;HOU Qiqi;HAN Quanle;ZHANG Boheng;ZHANG Jiawei;CAO Hongxia;ZHANG Chao;CHEN Shuohua;WU Shouling;LI Kangbo(Third Department of Urology,Tangshan Workers'Hospital,Tangshan 063000,China;Department of Cardiology,Tangshan Workers'Hospital,Tangshan 063000,China;Department of RehabilitationMedicine,Tangjiazhuang Hospital of Kailuan(Group)Co.,Ltd,Tangshan 063000,China;Cardiac Cathlab of Tangshan Workers'Hospital,Tangshan 063000,China;Department of Cardiology,Kailuan Hospital,Tangshan 063000,China;School of Clinical Medicine,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]河北省唐山市工人医院泌尿外三科,063000 [2]河北省唐山市工人医院心内科,063000 [3]河北省唐山市开滦(集团)有限责任公司唐家庄医院康复医学科,063000 [4]河北省唐山市工人医院导管室,063000 [5]河北省唐山市开滦总医院心内科,063000 [6]华北理工大学临床医学院,河北省唐山市063000

出　　处：《中国全科医学》2023年第36期4521-4526,共6页Chinese General Practice

基　　金：河北省医学重点科技研究计划(20221777)。

摘　　要：背景全球人群疾病负担报告显示,心房颤动与慢性肾脏病(CKD)成了近20年增长较快的死亡原因。心肾综合征的概念指出心房颤动可能增加新发CKD的发病风险,但目前国内外对心房颤动增加新发CKD发病风险的相关研究较少,并且与年龄的交互作用尚不明确。目的探讨中国北方人群心房颤动是否增加CKD发病风险。方法选取2006—2010年河北省开滦集团职工健康查体人群为研究对象,收集研究对象的一般资料和实验室检查结果,并对研究对象进行随访,末次随访时间2020-12-31,观察终点事件为新发CKD。根据是否患有心房颤动将患者分为非心房颤动组(n=110487)和心房颤动组(n=368)。用寿命表法计算患者新发CKD的累积发病率,采用KaplanMeier法绘制心房颤动组与非心房颤动组新发CKD累积发病率的生存曲线,并用Log-rank检验比较两组患者累积CKD发生率的差异。采用多因素Cox比例风险回归模型分析探究心房颤动对新发CKD发病风险的影响。结果心房颤动组患者年龄、男性比例、收缩压、舒张压、BMI、受教育程度、参加体育锻炼、高血压、糖尿病、服用降压药、服用降糖药比例、超敏C反应蛋白高于非心房颤动组,饮酒比例、总胆固醇、三酰甘油、低密度脂蛋白胆固醇低于非心房颤动组(P<0.05)。心房颤动组与非心房颤动组新发CKD的发生率和累积发病率比较,差异有统计学意义(P<0.05)。将研究对象按年龄进行分层,≤65岁研究对象心房颤动组与非心房颤动组新发CKD的发生率和累积发病率比较,差异有统计学意义(P<0.05);>65岁研究对象心房颤动组与非心房颤动组新发CKD的发生率比较,差异有统计学意义(P<0.05)。经校正后的多因素Cox比例风险回归模型分析结果显示,≤65岁人群心房颤动是新发CKD的危险因素[HR=1.350,95%CI(1.038,1.755),P=0.025]。结论心房颤动是中国北方人群新发CKD发病的独立危险因素,Background The global population disease burden report shows that atrial fibrillation(AF)and chronic kidney disease(CKD)have emerged as the fast-growing causes of death in the last 20 years.The concept of cardiorenal syndrome suggests that AF may increase the risk of new-onset CKD,however,there are few studies related to the increased risk of new-onset CKD with AF at home and abroad,and the interaction with age remains unclear atpresent.Objective To investigate whether AF increases the risk of new-onset CKD in northern Chinese population.Methods The population who attended a comprehensive health check-up for the employees of Kailuan Group in Hebei Province from 2006 to 2010 were selected as study subjects.The general information and laboratory test results of the study subjects were collected,and the study subjects were followed up with the final follow-up date of 2020-12-31 and the end point of new-onset CKD.The included patients were divided into AF group(n=368)and non-AF group(n=110487)according to the presence or absence of AF.The cumulative incidence of new-onset CKD in patients was calculated using the lifetable method.The Kaplan-Meier method was used to plot the survival curves of the cumulative incidence of new-onset CKD in the AF group and the non-AF group.The Log-rank test was used to compare the differences in the cumulative incidence of CKD between the two groups.The multivariate Cox proportional hazard regression model was used to explore the effect of AF on the risk of new-onset CKD.Results AF group was higher than non-AF group in age,male proportion,systolic blood pressure level,diastolic blood pressure level,body mass index,the proportions of education level,participation in physical exercise,hypertension,diabetes,taking hypotensive drugs and hypoglycemic drugs,and high-sensitivity C-reactive protein level(P<0.05).AF group was lower than non-AF group in the proportion of alcohol consumption,total cholesterol,triacylglycerol and low density lipoprotein cholesterinlevels(P<0.05).There were statistic

关 键 词：心房颤动 肾功能不全 慢性 发病率 队列研究 危险因素 相关性研究 

分 类 号：R541.75[医药卫生—心血管疾病]