血清胆红素水平和房颤的关系

Relationship between Serum Bilirubin Level and Atrial Fibrillation

目的探讨心房颤动与血清胆红素水平的关系。方法选择2017年9月至2018年7月在河南科技大学第一附属医院心脏科住院的房颤患者98例为观察组,同期住院的非心房颤动患者80例为对照组。详细记录入选患者的一般临床资料特征、合并疾病、实验室检查结果。采用经胸多普勒心脏超声测定左心房前后径、左心室舒张末期内径和左心室射血分数等;采用单因素分析及Logistic回归分析血清胆红素水平和房颤的关系。结果对照组血清胆红素水平明显高于观察组,总胆红素(14.45±5.94)VS(11.96±4.38),P=0.008;直接胆红素(2.79±1.44)VS(2.07±0.83),P=0.001;间接胆红素(11.66±4.94)VS(9.88±3.97),P=0.026。多元Logistic回归分析显示,左房扩大为房颤发生的独立危险因素[OR(95%CI),LAD1.145(1.061~1.237)];血清胆红素为房颤发生的独立保护因素[OR(95%CI),TBIL0.899(0.830~0.974)]。结论血清胆红素可能是房颤的保护因素之一,两者之间联系的可能机制有待于进一步研究。

Objective To investigate the potential relationship between the atrial fibrillation(AF)and bilirubin level.Methods Patients with and without AF hospitalized from September 2017 to July 2018 were screened in this study.The final study population consisted of 178 patients:98 patients with AF were enrolled,and 80 patients without AF were regard as the control group.The general clinical data,combined disease and laboratory examination results were collected Left atrium diameter(LAD),left ventricular end-diastolic dimension(LVEDD)and left ventricular ejection fraction(LVEF)were determined by doppler echocardiography.Univariate analysis and logistic regression were used to analyze the relationship between serum bilirubin levels and AF.Results After univariate analysis,serum bilirubin level in the control group was significantly higher than that in the observation group:serum bilirubin(14.45±5.94)VS(11.96±4.38),P=0.008;direct bilirubin(2.79±1.44)VS(2.07±0.83),P=0.001;indirect bilirubin(11.66±4.94)VS(9.88±3.97),P=0.026.After multivariate logistic regression analysis,left atrial enlargement was an independent risk factor for AF[OR(95%CI),LAD 1.145(1.061~1.237)],serum bilirubin levels was an independent protector of AF[OR(95%CI),TBIL 0.899(0.830~0.974)].Conclusion The high serum bili-rubin level may be an independent protective factor for the development of AF.Future larger studies should further evaluate this potential association as well as the underlying mechanisms.