冠心病合并心房颤动患者的相关危险因素分析  

Risk factors in patients with coronary heart disease complicated by atrial fibrillation

作　　者：刘贞杰 张艳玲 王灿灿 孔彦霞 Liu Zhenjie;Zhang Yanling;Wang Cancan;Kong Yanxia(Qingdao Rest Center of Special Service of Chinese PLA Navy,Qingdao 266071,China;不详)

机构地区：[1]海军青岛特勤疗养中心,青岛266071 [2]青岛市妇女儿童医院,青岛266000 [3]康复大学青岛医院(青岛市市立医院),青岛266000

出　　处：《中国循证心血管医学杂志》2023年第8期979-981,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 探讨冠状动脉粥样硬化性心脏病(冠心病)患者合并心房颤动(房颤)的危险因素。方法 选择2020年6月至2022年12月于青岛市市立医院和青岛市妇女儿童医院就诊的100例冠心病患者进行研究,根据合并房颤情况分为房颤组(n=34)和对照组(n=66),收集患者的临床资料,分析冠心病合并房颤的危险因素及其危险因素的预测价值。结果 单因素分析显示,两组患者年龄、性别、体质指数(BMI)、尿酸(UA)、肌酐(Cre)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左室射血分数(LVEF)及合并症比较,差异无统计学意义(P>0.05);两组脑钠肽(BNP)、左心房内径(LAD)、置入支架数量比较,差异有统计学意义(P<0.05)。多因素非条件Logistic分析显示,左心房内径、置入支架数量均是冠心病患者合并房颤的独立危险因素(P<0.05)。ROC结果显示,血清BNP预测冠心病合并房颤的AUC为0.910,灵敏度为82.59%,特异度为85.50%,截断值为398.57 pg/ml,左心房内径预测冠心病合并房颤的AUC为0.877,灵敏度为78.50%,特异度为73.20%,截断值为39.18 mm,置入支架数量预测冠心病房颤的AUC为0.851,灵敏度为83.40%,特异度为86.50%,截断值为2.50个(P<0.05)。结论 冠心病合并房颤患者的独立危险因素较多,BNP、左心房内径、置入支架数量均具有一定的预测价值,临床应针对上述危险因素进行积极干预,以改善患者预后。Objective To discuss the risk factors in patients with coronary heart disease(CHD) complicated by atrial fibrillation(AF).Methods CHD patients(n=100) were chosen from Qingdao Municipal Hospital and Qingdao Women's and Children's Hospital from June 2020 to Dec.2022.All patients were divided,according to AF occurrence,into AF group(n=34) and control group(n=66).The clinical materials were collected from the patients,and risk factors and their predictive value to CHD complicated by AF were analyzed.Results The results of single-factor analysis showed that the differences in age,gender,body mass index(BMI),uric acid(UA),creatinine(Cre),total cholesterol(TC),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C),left ventricular end-diastolic inner diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF) and complications had no statistical significance between 2 groups(P>0.05).The differences in brain natriuretic peptide(BNP),left atrial diameter(LAD) and number of implanted stents had statistical significance between 2 groups(P<0.05).The results of multi-factor non-conditional Logistic analysis showed that LAD and number of implanted stents were independent risk factors of CHD complicated by AF(P<0.05).The results of ROC curve analysis showed that,in predicting CHD complicated by AF,AUC of BNP was 0.910,sensitivity was 82.59%,specificity was 85.50% and cutoff value was 398.57 pg/ml,AUC of LAD was 0.877,sensitivity was 78.50%,specificity was 73.20% and cutoff value was 39.18 mm,and AUC of number of implanted stents was 0.851,sensitivity was 83.40%,specificity was 86.50% and cutoff value was 2.50(P<0.05).Conclusion There are many independent risk factors in patients with CHD complicated by AF,and BNP,LAD and number of implanted stents have some predictive value.These risk factors should be intervened actively for improve patients' prognoses in clinical practice.

关 键 词：冠心病 心房颤动 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]