吸烟与老年阵发性心房颤动的相关性研究

Relationship between smoking and paroxysmal atrial fibrillation in the elderly

目的探讨吸烟与老年阵发性心房颤动(房颤)的关系。方法连续入选2019年1月~2020年6月在天津市第五中心医院心内科住院的老年阵发性房颤患者141例作为房颤组,同期住院的非房颤患者140例作为对照组。记录2组一般临床资料、实验室检查指标,进行超声心动图检查,采用多因素logistic回归分析房颤的影响因素。结果房颤组吸烟(29.1%vs 7.1%)和高血压(78.7%vs 50.7%)比例、左心房内径及右心房内径较对照组增加,游离三碘甲状腺素原氨酸(FT3)水平[(3.92±0.82)mmol/L vs(4.28±0.68)mmol/L]较对照组降低,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析,吸烟(OR=6.297,95%CI:2.836~13.980,P=0.000)、高血压(OR=3.266,95%CI:1.827~5.838,P=0.000)为老年阵发性房颤发生的独立相关因素,FT3(OR=0.479,95%CI:0.323~0.710,P=0.000)与老年阵发性房颤呈负相关。结论吸烟与老年阵发性房颤独立相关,两者的可能机制有待进一步研究。

Objective To study the relationship between smoking and paroxysmal AF in the elderly.Methods One hundred and forty-one elderly paroxysmal AF patients admitted to our hospital from January 2019 to June 2020 served as a AF group and 140 paroxysmal AF-free patients admitted to our hospital during the same period served as a control group.Their general clinical data,laboratory testing and echocardiography parameters were recorded.The risk factors for AF in the elderly were analyzed by multivariate logistic regression analysis.Results The ratio of smokers and the incidence of hypertension were signiftcantly higher in AF group than in control group(29.1%vs 7.1%,P=0.000;78.7%vs 50.7%,P=0.000).The left atrial diameter and right atrial diameter were significantly longer while the serum FT3 level(3.92±0.82 mmol/L vs 4.28±0.68 mmol/L)was significantly lower in AF group than in control group(P<0.01,P<0.01).Multivariate logistic regression analysis showed that smoking and hypertension were the independent risk factors for paroxysmal AF in the elderly and FT3 was negatively related with paroxysmal AF in the elderly(OR=6.297,95%CI:2.836-13.980,P=0.000;OR=3.266,95%CI:1.827-5.838,P=0.000;OR=0.479,95%CI:0.323-0.710,P=0.000).Conclusion Smoking is an independent risk factor for paroxysmal AF in the elderly.The mechanism underlying the relationship between smoking and paroxysmal AF needs to be further studied.