摘要
目的分析非瓣膜性心房颤动(房颤)青年患者临床特征及相关危险因素的分布特点。方法回顾性分析2016年1月至2021年5月北部战区总医院心内科住院的非瓣膜性房颤青年患者267例,年龄(39.11±5.33)岁,年龄范围18~44岁,男233例(233/267,87.27%),女34例(34/267,12.73%)。通过电子病历系统收集患者的基本信息、实验室检查结果及房颤危险因素(包括吸烟、饮酒、血脂异常、超重/肥胖、高血压和糖尿病)。结果入选267例患者包括阵发性房颤181例(181/267,67.79%),持续性房颤86例(86/267,32.21%)。房颤危险因素中,患病率最高的3个因素依次为肥胖(205/267,76.78%)、血脂异常(159/267,59.55%)和吸烟(111/267,41.57%)。入选患者中≥1个危险因素的比率为91.76%(245/267)。阵发性房颤患者中合并其他类型心律失常比率明显高于持续性房颤患者(P<0.001)。多因素Logistic回归分析显示糖尿病是持续性房颤的独立危险因素,合并有糖尿病的患者表现为持续性房颤的比率增加(OR=5.30,95%CI 1.06~26.66,P=0.043)。受试者工作特征曲线(ROC)显示左心房内径40.5 mm、右心房左右径40.5 mm、右心房上下径47.5 mm是预测非瓣膜性房颤青年患者发生持续性房颤的最佳截断点。结论非瓣膜性房颤青年患者应尽早启动以戒烟、改善代谢、减轻体重为目的的生活方式干预,药物控制血糖、血压,以降低危险因素水平,有助于更好地预防房颤的发生发展。
Objective To observe the clinical characteristics and risk factors distribution features of young adults hospitalized with atrial fibrillation(AF).Methods A retrospective analysis of 267 young patients with AF,aged(39.11±5.33)years range 18-44 years,in Department of Cardiology,General Hospital of Northern Theater Command from January 2016 to May 2021.Among them,233 were male(233/267,87.27%)and 34 were female(34/267,12.73%).The general information and laboratory test were recorded.Risk factors for AF include were smoking,alcohol consumption,dyslipidemia,overweight/obesity,hypertension and diabetes.Results Two hundred and sixty-seven patients included 181 paroxysmal AF(181/267,67.79%),and 86 persistent AF(86/267,32.21%).Dyslipidemia(159/267,59.55%),obesity(205/267,76.78%)and smoking(111/267,41.57%)were the most important risk factors for young patients with AF,and most patients had one or more risk factors.The rate of complicated other arrhythmias was significantly higher in paroxysmal AF patients than that in persistent AF patients(P<0.001).Logistic regression analysis showed that diabetes significantly increased the risk of persistent AF(OR=5.30,95%CI 1.06-26.66,P=0.043).The receiver operating characteristic curve(ROC)showed that the left atrial diameter of 40.5 mm,the right atrial left-right diameter of 40.5 mm,and the right atrial upper-lower diameter of 47.5 mm,were the best cut-off points for predicting the occurrence of persistent AF in young patients with AF.Conclusion Young adults with AF should start lifestyle intervention as early as possible for the purpose of quitting smoking,improving metabolism and reducing weight,and control blood glucose and blood pressure with drugs to reduce the level of risk factors,which is helpful for us to better prevent the occurrence and development of AF.
作者
蔡文芝
孙鸣宇
王祖禄
梁明
金志清
Cai Wenzhi;Sun Mingyu;Wang Zulu;Liang Ming;Jin Zhiqing(Department of Cardiology,General Hospital of Northern Theater Command,Shenyang 110016,China;Department of Geratology,Liaocheng People′s Hospital,Liaocheng,252000,China)
出处
《中华心律失常学杂志》
2022年第4期377-382,共6页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
青年
危险因素
临床特征
糖尿病
Atrial fibrillation
Young adults
Risk factors
Clinical characteristics
Diabetes
