植入起搏器老年阵发性房颤患者发生血栓事件相关因素分析  

Analysis of Related Factors of Thrombotic Events in Elderly Patients with Paroxysmal Atrial Fibrillation Implanted with Pacemaker

作　　者：琚肖肖 李艳 宋昆鹏 JU Xiaoxiao;LI Yan;SONG Kunpeng(Second Ward of Cardiovascular Medicine Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450007,China)

机构地区：[1]郑州大学附属郑州中心医院心血管内科二病区,郑州450007

出　　处：《河南医学高等专科学校学报》2024年第5期567-571,共5页Journal of Henan Medical College

摘　　要：目的探讨植入起搏器的老年阵发性房颤患者的左室功能、血清白细胞介素-17A(IL-17A)、白蛋白(Alb)水平变化与血栓事件发生的关系。方法选取本院门诊长期随访的已植入起搏器的150例老年阵发性房颤患者作为研究对象,在入组当日检测左室功能、血清IL-17A和Alb水平;所有患者均随访2年,最终按随访期间有无血栓终点事件分为血栓组(n=20)与对照组(n=130),比较2组患者一般资料及左室功能、血清IL-17A、Alb水平差异,并分析其与血栓事件的相关性。结果随访2年,共发生血栓事件20例,包括14例脑卒中、6例外周动脉栓塞。血栓组高血压、糖尿病的比率均高于对照组,服用抗凝药物的比率低于对照组,差异有统计学意义(P<0.05);血栓组的左室射血分数(LVEF)水平低于对照组,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)水平高于对照组,差异有统计学意义(P<0.05);血栓组血清Alb水平低于对照组,IL-17A水平高于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,高血压、糖尿病、低左室功能、高血清IL-17A水平及低血清Alb水平均是影响植入起搏器老年阵发性房颤患者血栓事件发生的独立危险因素(P<0.05),服用抗凝药物是血栓事件的保护因素(P<0.05)。Spearman相关性分析显示,植入起搏器老年阵发性房颤患者左室功能中的LVESD、LVEDD及血清IL-17A水平与血栓事件呈正相关(P<0.05),LVEF及血清Alb水平与血栓事件呈负相关(P<0.05)。结论糖尿病、高血压、抗凝药物、左室功能及血清IL-17A、Alb是植入起搏器老年阵发性房颤患者血栓事件的影响因素。Objective To explore the relationship between changes in left ventricular function and serum levels of interleukin-17A(IL-17A)and albumin(Alb)and the occurrence of thrombotic events in elderly patients with paroxysmal atrial fibrillation implanted with pacemakers.Methods A total of 150 elderly patients with paroxysmal atrial fibrillation who had been implanted with pacemakers and were followed up for a long time in the outpatient department of our hospital were selected as the research objects.Left ventricular function and serum levels of IL-17A and Alb were detected on the day of enrollment.All patients were followed up for 2 years.Finally,according to the presence or absence of thrombotic end events during the follow-up period,they were divided into thrombus group(n=20)and control group(n=130).The general data,left ventricular function,serum levels of IL-17A and Alb were compared between the two groups,and their correlation with thrombotic events was analyzed.Results After 2 years of follow-up,a total of 20 thrombotic events occurred,including 14 cases of stroke and 6 cases of peripheral arterial embolism.The proportions of hypertension and diabetes in the thrombus group were higher than those in the control group,and the proportion of taking anticoagulant drugs was lower than that in the control group,with statistically significant differences(P<0.05).The level of left ventricular ejection fraction(LVEF)in the thrombus group was lower than that in the control group,and the levels of left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)were higher than those in the control group,with statistically significant differences(P<0.05).Serum Alb in the thrombus group was lower than that in the control group,and the level of IL-17A was higher than that in the control group,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that hypertension,diabetes,low left ventricular function,high serum IL-17A level and low serum Alb level wer

关 键 词：阵发性房颤 植入起搏器 左室功能 白细胞介素-17A 血清白蛋白 血栓事件 

分 类 号：R541.7[医药卫生—心血管疾病]