射血分数降低的心力衰竭病人持续性心房颤动危险因素研究

Risk factors for persistent atrial fibrillation in patients with heart failure with reducesd ejection fraction

目的探讨射血分数降低的心力衰竭(HFrEF)病人持续性心房颤动(房颤)的相关危险因素。方法收集南京市高淳人民医院2017年1~12月住院治疗的HFrEF合并房颤病人78例,根据病人房颤类型分为阵发性房颤组16例以及持续性房颤组62例。比较2组病人一般情况的差异,并应用多因素Logistic逐步回归分析及ROC曲线分析HFrEF合并持续性房颤的危险因素。结果与阵发性房颤组比较,持续性房颤组的左心房内径(LAD)、血尿酸水平、合并T2DM比例增高,BMI、合并心脏瓣膜病比例降低,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,LAD是心力衰竭病人持续性房颤的独立危险因素(OR=1.256,95%CI1.071~1.473)。ROC曲线显示,LAD最佳截断点为49.5 mm,敏感性为51.6%,特异性为41.5%,AUC为0.871。结论HFrEF病人持续性房颤受多种因素影响,其中LAD可能是HFrEF病人持续性房颤的独立危险因素。

Objective To study the risk factors of persistent atrial fibrillation(AF)in the patients with heart failure with reduced ejection fraction(HFrEF).Methods Totally 78 patients with HFrEF admitted in Gaochun People's Hospital from January to December 2017 were collected.According to the type of AF,the patients were divided into paroxysmal AF group(n=16)and persistent AF group(n=62).The risk factors for persistent AF were analyzed by multivariate Logistic regression analysis and receiver operator characteristic(ROC)curve analysis respectively.Results The levels of left atrial diameter(LAD),uric acid and the prevalence of type 2 diabetes were higher,and the level of body mass index,the prevalence of valvular heart disease were lower in persistent AF group than those in paroxysmal AF group(P<0.05).Multivariate Logistic regression analysis showed that LAD was the independent risk factor for patients with persistent AF(OR=1.256,95%CI1.071-1.473).ROC curve revealed that optimal cut-off point of LAD was 49.5 mm,and area under ROC curve was 0.871 with sensitivity and specificity of 51.6%and 41.5%.Conclusions LAD is an independent risk factor for persistent AF in the patients with HFrEF.