瓣膜置换术后高血糖与新发心房颤动的关系

Relationship between hyperglycemia and new onset atrial fibrillation after valve replacement

目的:探讨患者瓣膜置换术后高血糖与新发心房颤动(房颤)的相关性。方法:对我院2017-01-2018-02行瓣膜置换手术的328例患者进行回顾性分析,单因素分析筛选所有患者的新发房颤高危因素,并对有意义的变量进行多因素回归分析。同时分别对糖尿病和非糖尿病患者新发房颤的危险因素进行分析。结果:328例患者中,有118例出现了房颤,发生率为35.98%,单因素分析显示年龄、糖尿病史、左室射血分数(LVEF)、BMI、术后白细胞计数(WBC)、平均血糖值差异有统计学意义(P<0.05)。多因素logistic回归分析显示年龄、糖尿病史、BMI、术后WBC及平均血糖值是发生术后房颤的独立危险因素(P<0.05)。无论是否合并糖尿病,平均血糖水平均为新发房颤的独立危险因素。结论:患者瓣膜置换术后应激性高血糖是房颤发生的独立危险因素。

Objective：To explore the correlation between hyperglycemia after valve replacement and new onset atrial fibrillation.Method：The 328 patients with valve replacement from January 2017 to February 2018 in our hospital were analyzed retrospectively.Single factor analysis was used to screen all the high risk factors of new atrial fibrillation in all patients,and the significant variables were analyzed by multiple factor regression analysis.Meanwhile,the risk factors of new onset atrial fibrillation in diabetic and non-diabetic patients were analyzed.Result：The118 cases had atrial fibrillation in the 328 patients,and the incidence of which was 35.98%.Single factor analysis showed that age,diabetes history,left ventricular ejection fraction（LVEF）,BMI,postoperative WBC and mean blood glucose were statistically significant（P〈0.05）.Multivariate logistic regression analysis showed that age,diabetes history,BMI,postoperative WBC and mean blood glucose were independent risk factors for postoperative atrial fibrillation（P〈0.05）.Whether diabetes was combined or not,the average blood glucose level was an independent risk factor for new onset atrial fibrillation.Conclusion：Stress hyperglycemia after valve replacement is an independent risk factor for atrial fibrillation.