摘要
目的分析冠状动脉旁路移植术(CABG)后心房颤动(AF)发生的危险因素。方法回顾性分析本院401例行CABG的病历资料,根据术后住院期间(1周内)有无AF发生分为AF组与非AF组,比较两组临床资料,进行统计学分析,筛选CABG后AF的高危因素,比较两组患者术前超敏C反应蛋白(hs-CRP)水平。结果 CABG后AF发生率为27.93%(112/401)。单因素分析显示AF组年龄较大、病史较长、左房内径较大、血管桥数目较多,而射血分数(EF)值及术后β受体阻滞剂使用率显著低于非AF组(P均<0.05)。多因素Logistic回归分析显示年龄、AF病史、左房内径增大、低EF值及术后早期停用β受体阻滞剂是CABG后AF发生的独立危险因素(P均<0.05)。同时AF组术后平均ICU停留时间显著长于非AF组(42.35±20.04 h vs 35.50±12.58 h,P=0.001),术前hs-CRP水平显著高于非AF组(7.11±6.20 mg/L vs 5.17±8.22 mg/L,P=0.026)。结论高龄、AF病史、左房内径增大、低EF值和术后早期停用β受体阻滞剂是CABG后AF发生的高危因素,这些参数有助于预测CABG后AF的发生。CABG后应尽早恢复应用β受体阻滞剂,炎症因素可能参与了CABG后AF的发生。
Objective To analyze risk factors of atrial fibrillation （AF） following coronary artery bypass grafting （CABG）. Methods Four hundred and one patients with CABG were reviewed and divided into AF group and non-AF group on the basis of whether AF occurred after operation （within 1 week）. Statistical analysis was used to screen for risk fac- tors of AF following CABG. Results The rate of AF was 27.93% （ 114/401 ）. Univariate analysis showed that age, a history of AF, left atrial diameter, early postoperative withdrawal of β-blockers, grafting number were more than those in non-AF group, while EF value was lower than that in non-AF group（P〈0.05）. Multivariate logistic regression analysis showed that age, a histo- ry of AF, left atrial enlargement, lower EF and early postoperative withdrawal of β-blockers were independent risk factors of AF following CABG. The preoperative hs-CRP level of AF group was significantly higher than that in non-AF group（7.11±6.20 mg/ L vs 5.17±8.22 mg/L,P=0. 026）. Conclusions Advanced age, a history of AF, left atrial enlargement, lower EF and early postoperative withdrawal of β-blockers are independent risk factors of AF following CABG. Inflammation may be involved in the development of postoperative AF.
出处
《中国心脏起搏与心电生理杂志》
2013年第2期122-125,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
