摘要
目的分析老年心房颤动患者射频消融手术后复发情况及其影响因素。方法选取2017年8月-2019年8月济南市人民医院心内科收治的150例老年房颤患者,均行环肺静脉电隔离术,记录其1年内术后复发情况,同时收集其临床资料,采用Logistic多元回归模型分析术后复发与各危险因素的相互关系。结果与<75岁组相比,≥75岁组病程更长,合并糖尿病及脑梗死的比例更高,左心房内径增加而左室射血分数降低;<75岁组中,早期复发、治疗成功、治疗有效及晚期复发人数分别为15例(14.2%)、51例(48.1%)、37例(34.9%)、18例(17.0%),≥75岁组则分别为10例(22.7%)、19例(43.2%)、11例(25.0%)、14例(31.8%),2组早期复发率差异无统计学意义(P>0.05),≥75岁组晚期复发率显著高于<75岁组(P<0.05)。Logistic回归分析发现,年龄、病程、糖尿病、左心房内径、血高敏肌钙蛋白(high-sensitive cardiac troponin T,hs-TnT)及高敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)与术后复发相关。结论年龄≥75岁、病程延长、合并糖尿病、左心房内径增加、血hs-TnT及hs-CRP升高是老年房颤患者术后复发的危险因素,临床上应注意监测以上因素以识别复发高危患者,并予以积极处理。
Objective To analyze the recurrence and influencing factors in elderly patients with atrial fibrillation after radiofrequency ablation.Methods 150 elderly patients with atrial fibrillation who were treated in Department of Cardiology of People's Hospital of Jinan City fromAugust 2017 to August 2019 and received the treatment of circular pulmonary vein electrical isolation.Their postoperative recurrence within 1 year was recorded and clinical data were collected.Logistic multiple regression model was used to analyze the relationship between postoperative recurrence and various risk factors.Results Compared with<75 years old group,the course of disease of≥75 years old group was longer,the proportion of diabetes mellitus and cerebral infarction was higher,the diameter of the left atrium was increased and the left ventricular ejection fraction was decreased.In<75 years old group,the number of early recurrence,successful treatment,effective treatment and late recurrence were 15 cases(14.2%),51 cases(48.1%),37 cases(34.9%),18 cases(17.0%),respectively;in≥75 years old group,they were 10 cases(22.7%),19 cases(43.2%),11 cases(25.0%),and 14 cases(31.8%),respectively.There was no significant difference in the early recurrence rate between the two groups(P>0.05),but the late recurrence rate in≥the 75-year-old group was significantly higher than that in<75-year-old group(P<0.05).Logistic regression analysis showed that age,course of disease,diabetes mellitus,left atrial diameter,high-sensitivity cardiac troponin T(hs-TNT)and highsensitivity C-reactive protein(hs-CRP)were related to postoperative recurrence.Conclusion Age≥75 years,prolonged course of disease,diabetes,increased left atrial diameter,elevated blood hs-TnT and hs-CRP are risk factors for postoperative recurrence in elderly patients with atrial fibrillation.In clinical practice,attention should be paid to monitoring above risk factors so as to identify patients with high risk of recurrence,and actively deal with these risk factors.
作者
孙丽霞
苏霞
张燕
Sun Lixia;Su Xia;Zhang Yan(Department of Nursing,People's Hospital of Jinan City,Jinan,Shandong,271199,P.R.China;Department of Cardiology,People's Hospital of Jinan City,Jinan,Shandong,271199,P.R.China)
出处
《老年医学与保健》
CAS
2020年第6期956-960,共5页
Geriatrics & Health Care
基金
山东省医学会科研基金(YXH2020ZX037)。
关键词
老年
心房颤动
射频消融手术
相关因素
回归分析
elderly
atrial fibrillation
radiofrequency ablation
related factors
regression analysis
