影响老龄冠状动脉旁路移植术后新发心房颤动的危险因素

The Risk Factor Analysis for New Onset of Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting Surgery in Elder Patients

目的:目前尚缺乏针对老龄患者冠状动脉旁路移植术(Coroanry artery bypass grafting,CABG)后新发心房颤动(房颤)的风险因素分析。本研究以老龄CABG患者为研究对象,考察了影响老龄CABG后新发房颤的独立危险因素。方法:1999年至2005年间,有1 756例老龄患者(大于65岁)在我院接受首次单纯CABG术,确定潜在危险因素后,根据潜在危险因素收集患者数据,对影响术后新发房颤的潜在危险因素进行单因素分析和Logistic多因素回归分析,最终得出影响老龄CABG后新发房颤的独立危险因素。结果:1 756例患者中有285例(16.2%)发生术后房颤,有508例(28.9%)合并糖尿病,其中120例(23.6%)患者发生术后房颤。通过Logistic多因素回归分析表明合并糖尿病的风险比:2.07,P<0.001,年龄的风险比:1.09,P<0.001与老龄CABG后房颤具有独立的联系。结论:除年龄外,合并糖尿病亦是影响CABG后新发房颤的独立危险因素。

Objective：To assess the risk factors impacting the occurrence of post operative atrial fibrillation（POAF） in elder patients who underwent isolated coronary artery bypass grafting（CABG） surgery. Methods：We retrospectively studied 1,756 patients with the mean age of（69.0±3.6） years who underwent the first time of isolated coronary artery bypass grafting surgery from 1999 to 2005 in our hospital.We collected the clinical information of all patients and used logistic regression analysis to investigate the potential risk factors for the new onset of atrial fibrillation after CABG. Results：285/1756（16.2%） of patients suffered from POAF.508/1756（28.9%） of patients combined with diabetes mellitus before the operation,and 120/508（23.6%） of them had POAF.Multi logistic regression analysis presented that diabetes mellitus was an independent risk factor for POAF after CABG with the ratio of 2.07,P0.001.Age was another independent risk factor for POAF with the ratio of 1.09,P0.001. Conclusion：This was the first large-scale study demonstrated that diabetes mellitus was an independent risk factor for the occurrence of new onset of POAF after isolated CABG in patients elder than 65 years of age.