脓毒症患者新发心房颤动的影响因素及其对临床预后的影响分析  

Analysis of the influencing factors of new-onset atrial fibrillation in patients with sepsis and its impact on clinical prognosis

作　　者：孙杰 塔来白克·买买居马[3] 祁雷 SUN Jie;Talaibaike·Maimaijuma;QI Lei(Department of Emergency Medicine,Affiliated Hospital of Nantong University,Nantong Jiangsu 226001,China;Department of Emergency and Critical Care Medicine,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China;Department of Emergency,Xinjiang Kizilsu Kirgiz Autonomous Prefecture People's Hospital(Kezhou People's Hospital Affiliated to Nanjing Medical University),Kezhou Xinjiang 845350,China)

机构地区：[1]南通大学附属医院急诊医学科,江苏南通226001 [2]上海市浦东新区人民医院急诊与重症医学科,上海201299 [3]新疆克孜勒苏柯尔克孜自治州人民医院(南京医科大学附属克州人民医院)急诊科,新疆克州845350

出　　处：《临床和实验医学杂志》2024年第15期1587-1590,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市浦东新区重点学科群建设项目(编号:PWZxq2022-13);江苏省博士后科研资助项目(编号:2021K031A);江苏省科技副总项目(编号:FZ20210652)。

摘　　要：目的探讨分析脓毒症患者新发心房颤动的影响因素及其对临床预后的影响。方法选取于2021年5月至2023年1月在南通大学附属医院接受治疗的脓毒症患者186例,记录患者的一般资料、临床资料,根据患者是否合并新发心房颤动将患者分为观察组和对照组,观察组患者合并新发心房颤动,共96例,对照组患者为单纯脓毒症患者,共90例。比较两组患者的一般资料和临床资料的差异,采用多因素Logistic回归分析影响脓毒症患者新发心房颤动的因素,并比较两组患者的临床预后。结果观察组患者年龄、既往合并心力衰竭的患者比例分别为(72.15±6.96)岁、45.56%,均明显高于对照组[(68.52±8.45)岁、32.22%],差异均有统计学意义(P<0.05)。两组患者接受CRRT治疗以及器官衰竭中肝功能衰竭、呼吸衰竭等临床资料差异无统计学意义(P>0.05);且两组患者西地兰、抗胆碱能药物、胺碘酮、多巴胺、硝酸甘油等药物应用情况比较,差异均无统计学意义(P>0.05)。观察组患者急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分水平及机械通气、器官功能衰竭中急性肾损伤、代谢紊乱、凝血功能障碍、新发心力衰竭比例分别为(21.36±4.28)分、57.29%、40.63%、36.46%、17.71%、32.29%,均明显高于对照组[(18.36±5.12)分、41.11%、26.67%、22.22%、7.78%、18.89%],观察组患者应用茶碱类药物比例为51.04%,明显高于对照组(32.22%),差异均有统计学意义(P<0.05)。脓毒症患者年龄、APACHEⅡ评分、新发心力衰竭和使用茶碱类药物是脓毒症患者新发心房颤动的危险因素(P<0.05)。观察组患者的28 d病死率为50.00%,对照组患者的28 d病死率为43.33%,差异无统计学意义(P>0.05)。观察组患者在监护病房接受治疗的时间平均为(15.6±6.8)d,明显长于对照组[(13.7±5.5)d],差异有统计学意义(P<0.05)。结论脓毒症患者的年龄越大、APACHEⅡ评分越高、新发心力衰竭和�Objective To explore and analyze the influencing factors of new-onset atrial fibrillation in patients with sepsis and its impact on clinical prognosis.Methods A total of 186 patients with sepsis who received treatment in the Affiliated Hospital of Nantong University from May 2021 to January 2023 were selected.The general and clinical data of the patients were recorded.According to whether the patients had new atrial fibrillation,the patients were divided into the observation group and the control group.The control group consisted of 90 patients with simple sepsis.The general and clinical data of the two groups were compared,the influencing factors of new-onset atrial fibrillation in patients with sepsis were analyzed by multivariate Logistic regression analysis.The clinical prognosis of the two groups was compared.Results The age and proportion of patients with heart failure in the observation group were(72.15±6.96)years and 45.56%,respectively,which were significantly higher than those in the control group[(68.52±8.45)years and 32.22%],the differences were statistically significant(P<0.05).There was no statistically significant difference in clinical data such as CRRT treatment and liver failure and respiratory failure in organ failure between the two groups(P>0.05).There were no statistically significant differences in the application of cedilanid,anticholinergic drugs,amiodarone,dopamine,nitroglycerin and other drugs between the two groups(P>0.05).The acute physiology and chronic health status evaluationⅡ(APACHEⅡ)score level and the proportion of acute kidney injury,metabolic disorder,coagulation dysfunction and new heart failure in mechanical ventilation and organ failure in the observation group were(21.36±4.28)points,57.29%,40.63%,36.46%,17.71%and 32.29%,respectively,which were significantly higher than those in the control group[(18.36±5.12)points,41.11%,26.67%,22.22%,7.78%and 18.89%],the proportion of theophylline drugs in the observation group was 51.04%,which was significantly higher than that i

关 键 词：脓毒症 心房颤动 预后 危险因素 

分 类 号：R459.7[医药卫生—急诊医学] R541.75[医药卫生—治疗学]