动脉粥样硬化合并心房颤动的影响因素研究

Influencing Factors of Atrial Fibrillation in Patients with Atherosclerosis

目的探讨动脉粥样硬化(AS)合并心房颤动(AF)的影响因素,为AS合并AF的有效防治提供参考。方法选取2014年12月—2016年12月泰州市人民医院心内科收治的AS患者222例,其中未合并AF者137例(对照组),合并AF者85例(观察组);根据AF类型将AS合并AF患者分为阵发性AF者51例(A组)和持续性AF者34例(B组)。回顾性分析所有患者临床资料,包括一般资料[包括性别、年龄、吸烟史、冠心病(CHD)病史及血压]、血脂指标[包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]及影像学检查指标[包括左心房内径(LAD)和颈总动脉内膜中层厚度(IMT)]。AS合并AF的影响因素及AS合并阵发性AF的影响因素分析采用多因素Logistic回归分析。结果对照组和观察组患者性别、年龄、吸烟史、收缩压、舒张压、TG、LAD及颈总动脉IMT比较,差异有统计学意义(P<0.05);对照组和观察组患者CHD病史、TC、LDL-C及HDL-C比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄[OR=1.075,95%CI(1.039,1.111)]、收缩压[OR=1.066,95%CI(1.023,1.111)]、LAD[OR=1.089,95%CI(1.025,1.157)]、颈总动脉IMT[OR=1.022,95%CI(1.008,1.036)]是AS合并AF的危险因素(P<0.05)。A组和B组患者年龄、吸烟史、舒张压及TG比较,差异有统计学意义(P<0.05);A组和B组患者性别、CHD病史、收缩压、TC、LDL-C、HDL-C、LAD及颈总动脉IMT比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄[OR=1.095,95%CI(1.039,1.155)]、舒张压[OR=1.409,95%CI(1.191,1.668)]及TG[OR=1.039,95%CI(1.019,1.059)]是AS合并持续性AF的危险因素(P<0.05)。结论年龄、收缩压、LAD、颈总动脉IMT是AS合并AF的危险因素,年龄、舒张压及TG是AS合并持续性AF的危险因素,应引起临床重视。

Objective To investigate the influencing factors of atrial fibrillation in patients with atherosclerosis,to provide references for the effective prevention and treatment. Methods From December 2014 to December 2016,a total of 222 patients with atherosclerosis were selected in the Department of Cardiology, the People＇ s Hospital of Taizhou, thereinto 137 patients without atrial fibrillation were served as control group,85 patients with atrial fibrillation were served as observation group; according to types of atrial fibrillation,patients of observation group were divided into A group（ with paroxysmal atrial fibrillation,n = 51） and B group（ with persistent atrial fibrillation, n = 34）. Clinical data was retrospectively analyzed,including general information（ including gender,age,smoking history,history of coronary heart disease and blood pressure）,blood lipids index（ including TC,TG,LDL-C and HDL-C） and imageological examination results（ including LAD and IMT of common carotid artery）. Influencing factors of atrial fibrillation in patients with atherosclerosis and influencing factors of persistent atrial fibrillation in patients with atherosclerosis were analyzed by multivariate Logistic regression analysis. Results There were statistically significant differences of gender,age,smoking history,SBP,DBP,TG,LAD and IMT of common carotid artery between control group and observation group（ P〈0. 05）,while no statistically significant differences of history of coronary heart disease,TC,LDL-C or HDL-C was found between control group and observation group（ P〈0. 05）. Multivariate Logistic regression analysis results showed that,age [OR = 1. 075,95% CI（ 1. 039,1. 111） ],SBP [OR = 1. 066,95% CI（ 1. 023,1. 111） ],LAD [OR = 1. 089,95% CI（ 1. 025,1. 157） ]and IMT of common carotid artery [OR = 1. 022,95%CI（ 1. 008,1. 036） ] were influencing factors of atrial fibrillation in patients with atherosclerosis（ P〈0. 05）. There were statistically significant differences of age,smoking history,DBP and TG between A group and B group（ P〈0. 05）,while no statistically significant differences of gender,history of coronary heart disease,SBP,TC,LDL-C,HDL-C,LAD or IMT of common carotid artery was found between A group and B group（ P〉0. 05）. Multivariate Logistic regression analysis results showed that,age [OR = 1. 095,95% CI（ 1. 039,1. 155） ],DBP [OR = 1. 409,95% CI（ 1. 191,1. 668） ] and TG [OR= 1. 039,95% CI（ 1. 019,1. 059） ] were influencing factors of persistent atrial fibrillation in patients with atherosclerosis（ P〈0. 05）. Conclusion Age, SBP, LAD and IMT of common carotid artery are influencing factors of atrial fibrillation in patients with atherosclerosis, while age, DBP and TG are influencing factors of persistent atrial fibrillation in patients with atherosclerosis,which should pay more attentions to.