摘要
目的分析老年慢性心衰(CHF)合并心房颤动(AF)患者心脏结构变化特点及发生AF的相关因素。方法选取2018年6月至2021年6月268例CHF患者,按照是否合并AF分为合并AF组(90例)与非AF组(178例)。收集两组基础资料,采用心脏超声测量两组心脏功能,分析其心脏结构变化特点,并探讨其影响因素。结果合并AF组年龄(68.05±1.45)岁、静息心室率(102.35±9.87)次/min、血浆BNP(1138.25±102.41)pg/mL,均高于非AF组的(67.36±1.18)岁、(87.41±11.16)次/min、(1006.37±110.58)pg/mL(P<0.05),合并AF组的NYHA心功能分级Ⅳ级比例27.78%,高于非AF组的15.73%;合并AF组LVEF为(50.01±6.59)%低于非AF组的(52.83±6.75)%,LVEDD、LAD分别为(55.92±8.03)mm、(45.28±5.81)mm,高于非AF组的(53.64±8.17)mm、(42.65±5.36)mm(P<0.05)。多元逐步回归分析显示,静息心室率、血浆BNP水平、LVEF、LAD均为CHF合并AF的高危因素,LVEF是保护因素(P<0.05)。结论老年CHF合并AF患者心脏结构变化显著,左房内径增大,左室射血分数降低;血浆BNP水平、静息心室率和LAD是CHF合并AF的危险因素,而LVEF为CHF合并AF的保护因素。
Objective To analyze the characteristics of changes in the cardiac structure of elderly patients with chronic heart failure(CHF)and atrial fibrillation(AF).Methods A total of 268 CHF patients diagnosed and treated in our hospital from June 2018 to June 2021 were selected and divided into 90 combined AF group and 178 non-AF group according to whether they were combined with AF.The basic data of the two groups were collected,the cardiac function of the two groups was measured by echocardiography,the changes of the cardiac structure were analyzed,and the influencing factors were discussed.Results The age,resting ventricular rate(102.35±9.87)beats/min,and plasma BNP(1138.25±102.41)pg/mL in the combined AF group were higher than those in the non-AF group(67.36±1.18),(87.41±11.16)times/min,(1006.37±110.58)pg/mL(P<0.05),the proportion of NYHA cardiac function class IV in the combined AF group was 27.78%,higher than 15.73%in the non-AF group;LVEF in the combined AF group was(50.01±6.59)%lower than that of the non-AF group(52.83±6.75)%,LVEDD and LAD were(55.92±8.03)mm and(45.28±5.81)mm,respectively,higher than the non-AF group(53.64±8.17)mm,(42.65±5.36)mm(P<0.05).Multiple stepwise regression analysis showed that resting ventricular rate,plasma BNP level,LVEF,and LAD were all high-risk factors for CHF complicated with AF,and LVEF was a protective factor(P<0.05).Conclusion Elderly patients with chronic heart failure and atrial fibrillation comorbidities are older,with increased left atrial diameter,decreased left ventricular ejection fraction,and significant changes in cardiac mechanisms.The risk factors of CHF complicated with AF are plasma BNP level,resting ventricular rate and LAD,while LVEF is a protective factor for CHF and AF.
作者
秦越
QIN Yue(Department of General Medicine,Central Hospital of Jiamusi City,Jiamusi 154002,Heilongjiang Province,China)
出处
《罕少疾病杂志》
2023年第1期39-40,共2页
Journal of Rare and Uncommon Diseases
关键词
心力衰竭
心房颤动
老年
心脏结构
Heart Failure
Atrial Fibrillation
Old Age
Heart Structure
