摘要
目的探讨冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素。方法连续收集中国人民解放军总医院2011年1月至2012年12月入院治疗的冠状动脉粥样硬化性高血压患者,对其心房颤动发生的危险因素进行回顾性研究。按照收缩压≥140 mm Hg(1 mm Hg=0.133 kPa)或舒张压≥90 mm Hg定义为高血压患者,采用单因素及Logistic回归模型分析冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素。结果 3990例冠状动脉粥样硬化患者符合标准入选,其中137例并发心房颤动,心房颤动发生率为3.4%。动脉粥样硬化并发心房颤动组较单纯动脉粥样硬化组年龄更大(P<0.01)、心率更快(P<0.01)、吸烟者更少(P=0.021)、饮酒者更少(P=0.035);超声心动图检查结果显示左心室收缩末容量更大(P<0.01),左心室舒张末容量更大(P<0.01),左心室收缩末内径更大(P<0.01),左心室舒张末内径更大(P<0.01),左心室射血分数更小(P<0.01),左心房前后径更大(P<0.01),缩短分数更小(P<0.01);生化检测血钾浓度更高(P=0.014)。多因素Logistic回归分析冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素,发现年龄(OR=1.033,P=0.001)、左心房前后径(OR=1.183,P=0.000)是其发生的独立危险因素。结论年龄、左心房前后径是冠状动脉粥样硬化性高血压患者发生心房颤动的独立危险因素。
Objectives To explore the correlation between incidence of atrial fibrillation （AF） and coronary atheroselerosis with hypertension. Methods Patients with stable coronary atherosclerosis hospitalized in PLA General Hospital from January 2011 to December 2012 were included in this analysis （n=3 990）. Echocardiography and related biochemical parameters were analyzed. We divided the patients into 2 groups according to blood pressure： systolic pressure （SBP） ≥ 140 mm Hg （ 1 mm Hg=0.133 kPa） or diastolic pressure （DBP） ≥90 mm Hg in hypertensive group, SBP〈140 mm Hg and DBP〈90 mm Hg in non-hypertensive grouop. Logistic regression was used to analyze the independent risk factors of AF in patients with coronary atheroselerosis and hypertension. Results A total of 137 patients were diagnosed with AF （3.4%）. （1） Compared to stable coronary atherosclerosis patients without AF, stable coronary atherosclerosis patients with AF had older age （P〈0.01）, higher heart rate （P〈0.01）, lower proportion of smoking （P=0.021）, lower proportion of drinking （P=0.035）, larger left ventricular end-systolic volume （LVESV） （P〈0.01）, larger left ventricular end-diastolic volume （LVEDV） （P〈0.01）, larger left ventricular end-systolic dimension （LVESD） （P〈0.01）, larger left ventrieular end-diastolic dimension （LVEDD） （P〈0.01）, lower left ventricular ejection fraction （LVEF） （P〈0.01）, larger left atrial diameter （LAD） （P〈0.01）, lower fractional shortening （FS） （P〈0.01） and higher serum eoneentration of kalium （P=0.014）. After adjustment risk for higher blood pressure, multiple Logistic analysis revealed that mild hypertension was related with the incidence of AF. Age （OR= 1.033, P=0.001） and LAD （OR=1.183,P=0.000） were the independent risk factors for AF. Conclusions Age and LAD are independent risk factors for AF in patients with coronary atherosclerosis with hypertension.
出处
《岭南心血管病杂志》
2016年第2期149-152,180,共5页
South China Journal of Cardiovascular Diseases
关键词
冠状动脉疾病
高血压
心房颤动
危险因素
coronary atherosclerosis
hypertention
atrial fibrillation
risk factors
