摘要
目的 分析不同类型非瓣膜性心房颤动(NVAF)住院患者的临床特征,并探讨患者发生非阵发性房颤独立预测因素。方法 收集2019年10月至2022年2月于贵州省人民医院心内科及北京小汤山医院康复中心住院,经心电图及心脏超声确诊的NVAF患者297例,其中阵发性房颤197例,非阵发性房颤100例。比较两组患者一般临床资料、实验室指标、心脏超声结果等,并探讨患者合并非阵发性房颤的独立预测因素。结果 非阵发性房颤组与阵发性房颤组相比,吸烟率(34%比22.8%)、心力衰竭患病率(41.0%比22.3%)、抗凝治疗比例(79.0%比59.9%)均明显升高,B型脑钠肽(BNP)[178(131,302)pg/ml比123(59,216)pg/ml]、纤维蛋白原(Fbg)水平[2.9(2.4,3.5)μg/ml比2.7(2.3,3.1)μg/ml]均升高,左心房前后径(LAD)增大[38(35,42)mm比34(29,39)mm],但外周血管疾病的患病率较低(30.0%比46.0%),上述两组间差异均具有统计学意义(均P<0.05)。logistic多因素回归分析提示,校正混杂因素之后,LAD(OR=1.079,95%CI 1.033~1.126,P=0.001)、房颤病程(OR=1.006,95%CI 1.001~1.013,P=0.003)、外周血管疾病(OR=0.523,95%CI 0.281~0.972,P=0.041)为发生非阵发性房颤的独立预测因素。结论 非阵发性房颤患者吸烟率、心力衰竭患病率和抗凝治疗比例较大,BNP及Fbg表达水平升高,LAD增大,外周血管疾病的患病率较低。LAD增大、房颤病程延长是患非阵发性房颤的独立预测因素。
Objective To analyze the clinical features of hospitalized patients with different types of non-valvular atrial fibrillation(NVAF),and to explore the independent predictors of non-paroxysmal atrial fibrillation.Methods From October 2019 to February 2022,297 patients with NVAF who was hospitalized in the Guizhou Provincial People’s Hospital and the Rehabilitation Center of Beijing Xiaotangshan Hospital were collected, including 197 cases of paroxysmal atrial fibrillation and 100 cases of non-paroxysmal atrial fibrillation.The general clinical data, laboratory indexes, and cardiac ultrasound results of the two groups were compared, and the independent predictors of non-paroxysmal atrial fibrillation were discussed. Results Compared with the paroxysmal atrial fibrillation group, the smoking rate(34% vs.22.8%),the prevalence of heart failure(41.0% vs 22.3%),and the proportion of anticoagulation therapy(79.0% vs.59.9%)of non-paroxysmal atrial fibrillation group was significantly higher, and the B-type natriuretic peptide(BNP)[178(131,302)pg/ml vs 123(59,216)pg/ml],fibrinogen(Fbg)levels[2.9(2.4,3.5)μg/ml vs 2.7(2.3,3.1)μg/ml]were both increased, and the anteroposterior diameter of the left atrium(LAD)was enlarged[38(35,42)mm vs 34(29,39)mm],but the prevalence of peripheral vascular disease was lower(30.0% vs.46.0%),and the difference between the two groups was statistically significant(P<0.05).Logistic multivariate regression analysis suggested that after adjusting for confounders, LAD(OR=1.079,95% CI 1.033~1.126,P=0.001),course of atrial fibrillation(OR=1.006,95% CI 1.001~1.013,P=0.003),and peripheral vascular disease(OR=0.523,95% CI 0.281~0.972,P=0.041)was independent predictors of non-paroxysmal atrial fibrillation.Conclusion The prevalence of smoking, heart failure and anticoagulation in patients with non-paroxysmal atrial fibrillation was huge, the expression levels of BNP and Fbg were increased, LAD was enlarged, and the prevalence of peripheral vascular disease was low.Dilated LAD and prolonged duration of atrial fibrillation are independent predictors of non-paroxysmal atrial fibrillation.
作者
胥亚楠
杨龙
郭楚娴
赵冬琰
XU Yanan;YANG Long;GUO Chuxian;ZHAO Dongyan(Ward 2 Tiantan Xiaotangshan Rehabilitation Center,Beijing XiaoTangshan Hospital,Beijing 102211;Guizhou Provincial People's Hospital,Guizhou 550002,China)
出处
《中国老年保健医学》
2023年第1期6-9,共4页
Chinese Journal of Geriatric Care
基金
北京市医院管理中心青年人才培养“青苗”计划(编号:QML20212201)。
关键词
心房颤动
非阵发性房颤
吸烟
血管疾病
atrial fibrillation
non-paroxysmal atrial fibrillation
smoking
peripheral vascular disease
