高龄心房颤动伴功能性三尖瓣反流的危险因素分析  

Risk factors of atrial fibrillation with tricuspid regurgitation in the elderly

作　　者：纪禹同 徐加加 林仲秋 刘瑞瑛 黄建玉 全馨雪 徐琳 JI Yutong;XU Jiajia;LIN Zhongqiu;LIU Ruiying;HUANG Jianyu;QUAN Xinxue;XU Lin(Department of Geriatric Cardiovascular,General Hospital of Southern Theatre Command,Guangdong 510010,China)

机构地区：[1]中国人民解放军南部战区总医院老年心血管内科,510010

出　　处：《心肺血管病杂志》2024年第2期129-133,163,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：广州市科技计划项目(2023A03J0170);国家重点研发计划“常见多发病防治研究”专项(2021YFC2500600);中国人民解放军南部战区总医院育才基金(2022NZC001);国家老年疾病临床医学研究中心项目(NCRCG-PLAGH-2023006)。

摘　　要：目的:分析高龄心房颤动伴功能性三尖瓣反流的危险因素。方法:选取242例高龄心房颤动伴三尖瓣反流患者作为研究对象,跟踪随访1年,分析入组和随访1年后相关指标的差异性。采用Logistic回归分析、ROC曲线分析高龄心房颤动伴三尖瓣反流的影响因素及预测因子。结果:与入组时相比,随访1年后数据显示三尖瓣反流量明显增加,平均值为(7.1±0.5)m L,范围波动在0~40mL,且肌酐、尿酸、同型半胱氨酸(homocysteine,HCY)、三尖瓣反流、左心房左右径、左心房前后径、左心房上下径、右心房左右径、右心房上下径、LVEDD、LVESD、右心室内径及永久心脏起搏器置入术,差异有统计学意义(P<0.05)。三尖瓣反流组和非反流组在肌酐、尿素氮、胱抑素C、HCY、NT-proBNP、左心房左右径、左心房前后径、左心房上下径、右心房左右径、右心房上下径、右心室内径、LVEF、冠心病、高血压、慢性心力衰竭、慢性肾功能不全、永久心脏起搏器置入术,两组间差异有统计学意义(P<0.05)。其中,高龄心房颤动伴三尖瓣反流可能受右心房左右径(P=0.028)、永久心脏起搏器置入术(P=0.001)等因素影响;ROC曲线分析发现,右心房左右径(曲线下面积=0.753)、永久心脏起搏器置入术(曲线下面积=0.682)是高龄心房颤动患者发生三尖瓣反流的危险因素。结论:右心房左右径、永久心脏起搏器置入术不仅与高龄心房颤动伴三尖瓣反流存在关联性,也可作为高龄心房颤动伴功能性三尖瓣反流的预测因子。Objective:To analyze the risk factors of severe functional tricuspid regurgitation inthe elderly of atrial fibrillation patients.Methods:A total of 242 elderly patients with atrial fibrillation without tricuspid regurgitation were selected as the study subjects.By following up for 1 year,analyzed and compared the data collected at the time of enrollment and after 1 year of follow-up.Logistic regression analysis and ROC curve were used to analyze the influencing factors of atrial fibrillation with tricuspid regurgitation in the elderly.Results:Compared with the enrolled population,the data after 1 year of follow-up showed that tricuspid regurgitation increased significantly,with an average value of(7.1±0.5)mL and range of 0-40mL,and Cr(P=0.011),UA(P=0.015),homocysteine(HCY)(P=0.017),tricuspid regurgitation(P=0.001),left atrial left and right diameter(P-0.002),left atrial anteroposterior diameter(P-0.001),left atrial upper and lower diameter(P-0.001),right atrial left and right diameter(P-0.001),right atrial upper and lower diameter(P-0.003),the left ventricular end diastolic diameter(P-0.046),left ventricular end systolic diameter(P-0.013)and right ventricular diameter(P-0.002),permanent pacemaker implantation(P=0.042)were significantly different between the two groups.Further study was carried out on Cr(P=0.035),urea nitrogen(P-0.011),cystatin C(P-0.047),HCY(P-0.010),NT-proBNP(P-0.001),left atrial left and right diameter(P-0.001),left atrial anteroposterior diameter(P-0.001),left atrial upper and lower diameter(P-0.001),right atrial left and right diameter(P-0.001),right atrial upper and lower diameter(P-0.001),right ventricular diameter(P-0.042),LVEF(P-0.006),coronary heart disease(P-0.001),hypertension(P=0.021),chronic heart failure(P-0.003),chronic renal insufficiency(P=0.005),and permanent pacemaker implantation(P=0.001)were different between tricuspid regurgitation group and non-regurgitation group.Among them,atrial fibrillation with tricuspid regurgitation in the elderly may be affected by right atrial lef

关 键 词：心房颤动 三尖瓣反流 高龄 永久心脏起搏器置入术 

分 类 号：R54[医药卫生—心血管疾病]