慢性阻塞性肺病患者心房颤动与心脏结构的关联性

Relationship between primary atrial fibrillation and cardiac structure in patients with chronic obstructive pulmonary disease

目的分析慢性阻塞性肺病(COPD)患者初发心房颤动与心脏结构的关联性。方法将426例COPD患者分成窦性心律组(n=376)和初发房颤组(n=50)通过单因素分析得出COPD初发房颤的影响因素,再运用logistic回归分析COPD患者初发房颤的高危因素。结果单因素分析显示与窦性心律组比较,初发房颤组患者在年龄、冠心病史、右心室内径(RVD)、左心房内径(LAD)、右心房内径(RAD)、肺动脉内径(PAD)方面差异具有统计学意义(P<0.05),在初发房颤影响因素logistic回归分析中LAD(P<0.05)、RAD(P<0.05)是COPD患者初发房颤的危险因素。结论 COPD患者初发房颤与心脏结构有关联,左心房及右心房增大是COPD患者初发房颤的独立相关因素。

AIM To study the relationship between atrial fibrillation （AF） and cardiac structure in patients with chronic obstructive pulmonary disease （COPD）. METHODS A total of 426 COPD patients were divided into two groups ： sinus rhythm group （ n = 376） and primary atrial fibrillation group （n = 50）. Logistic regression analysis was conducted to evaluate the relation between AF and factors such as age, gender, COPD duration, underlying diseases, drug use and echocardiography results. RESULTS Univariate analysis indicated a significant difference in age, history of coronary heart disease, right ventricular diameter, left atrium diameter, right atrial diameter and pulmonary artery diameter （P 〈 0. 05）. Stepwise logistic regression analysis showed that left atrium diameter （P 〈 0. 05） and right atrial diameter （ P 〈 0.05 ） were risk factors for primary atrial fibrillation. CONCLUSION In COPD patients with AF, pulmonary artery pressure obviously increases and left and right atrium diameters obviously enlarge. Left and right atrium diameters are predictors for AF occurrence.