冠心病心力衰竭患者心房颤动的危险因素分析

Risk factors of atrial fibrillation in patients with coronary heart failure

目的:探讨冠心病心力衰竭患者心房颤动的危险因素。方法:选取冠心病心力衰竭合并心房颤动的患者30例(心房颤动组),另选取同期冠心病心力衰竭无心房颤动患者30例(非心房颤动组),比较2组患者的基线资料、检查指标的差异;利用Logistic回归及受试者工作特征曲线(ROC)分析冠心病心力衰竭患者发生房颤的危险因素。结果:心房颤动组B型脑钠肽(BNP)、左心房内径、置入冠脉支架个数明显大于非心房颤动组(均P<0.05)。多因素Logistic回归分析显示血BNP、左心房内径、置入冠脉支架个数为心房颤动的独立危险因素(均P<0.05)。ROC曲线显示血BNP最佳截点为482.0 pg/mL,敏感性60.00%,特异性96.70%,左心房内径最佳截点为40.16 mm,敏感性76.67%,特异性86.67%,置入冠脉支架个数最佳截点为2.5个,敏感性63.33%,特异性70.00%。结论:冠心病心力衰竭患者发生心房颤动受多种因素影响,其中血BNP、左心房内径和置入冠脉支架个数可能是冠心病心力衰竭患者发生心房颤动的独立危险因素。

Objective:To analyze the risk factors of atrial fibrillation(AF)in patients with coronary heart failure(CHF).Methods:Thirty CHF patients with AF were selected as the AF group,and 30 CHF patients without AF served as the non-AF group.The baseline information of the two groups was compared,and the risk factors for AF occurrence were screened by logistic regression analysis and receiver operator characteristic(ROC)curve analysis respectively.Results:The brain natriuretic peptide(BNP),left atria diameter(LAD)and the number of implanted stents in the AF group were significantly increased as compared with those in the non-AF group(all P<0.05).Logistic regression analysis indicated that BNP,LAD and the number of implanted stents were the independent risk factors for AF occurrence.Additionally,ROC curve revealed that optimal cut-off point of BNP was 482.0 pg/mL with a sensibility of 60.00%and a specificity of 96.70%,that of LAD was 40.16 mm with a sensibility of 76.67%and a specificity of 86.67%,and that of the number of implanted stents was 2.5 with a sensibility of 63.33%and a specificity of 70.00%.Conclusions:Various factors impact the occurrence of AF,but BNP,LAD and the number of the implanted stents may be the independent risk factors for CHF patients.