不同年龄段冠心病患者冠状动脉搭桥术后新发房颤的临床分析

Clinical analysis of new onset atrial fibrillation after coronary artery bypass grafting in different ages of patients with coronary heart disease

目的探讨不同年龄段冠心病患者单纯冠状动脉搭桥（CABG）术后新发房颤（POAF）的危险因素。方法回顾性分析2014年7月至2016年7月233例单纯行CABG术后患者的临床资料，根据患者年龄分为四组，分析不同年龄段患者CABG术后POAF的发生率及相关危险因素。结果CABG术后POAF的发生率随年龄增大而升高，且同一年龄段男性患者的发生率明显高于女性；年龄〈65岁患者发生房颤多与肥胖、吸烟、高脂血症有关；年龄≥65岁患者发生房颤多与高血压、糖尿病、左房增大有关；年龄〈65岁与I〉65岁患者对比，搭桥支数、术前射血分数、三酰甘油组间比较差异有统计学意义（P〈0．05）。结论不同年龄段CABG术后POAF的发生危险因素存在差异，根据年龄、性别等特点进行针对性综合干预，对于预防术后POAF具有重要的临床意义。

Objective To investigate the risk factors of new-onset atrial fibrillation （POAF） in different ages of patients with coronary artery disease after coronary artery bypass grafting （CABG）. Methods From July 2014 to July 2016, the clinical data of 233 patients underwent CABG were retrospectively analyzed, the patients were divided into four groups according to age. The incidence and related risk factors of POAF after CABG in patients with different ages were analyzed. Results The POAF incidence after CABG increased with age and the incidence of male patients was higher than that of the same age female; POAF in patients with aged 〈 65 years were correlated with obesity, smoking, hyperlipidemia; POAF in patients with aged ≥65 years were correlated with hypertension, diabetes, left atrial enlargement; for patients with aged 〈 65 years and ≥ 65 years, there was significant difference in bypass count, preoperative ejection fraction, triglycerides between the groups. Conclusions There is significant difference in the risk factors of POAF after CABG in patients with different ages, targeted integrated interventions based on age, sex and other characteristics should be made, and has important significance in the prevention of postoperative POAF.