甲状腺功能亢进患者发生房颤的危险因素

Risk factors of atrial fibrillation in patients with hyperthyroidism

目的探讨甲状腺功能亢进(甲亢)患者发生房颤的危险因素。方法从我院诊断为甲亢的755例患者中,选取首次发生房颤的112例作为研究组,未发生房颤的112例作为对照组。分析和比较两组的甲状腺功能指标(FT3、FT4、TSH、TPOAB、TGAB、TRAB)、胆固醇、三酰甘油、高血压病史、糖尿病病史、吸烟史、左右房(室)内径、射血分数、P波最大时限(the maximum P-wave duration,P_(max))、P波离散度(P-wave dispersion,PWD)。对上述可能的危险因素进行多因素Logistic回归分析。结果两组的FT3、TSH、高血压史、左右房内径、P_(max)、PWD比较,差异有统计学意义(P<0.05)。回归分析结果表明:TSH、高血压史、左房内径、PWD是甲亢患者发生房颤的独立危险因素。结论甲亢患者若TSH较低,或伴左心房肥大、PWD增大、有高血压史时,应高度警惕发生房颤的可能,并早期进行临床干预,以减少远期并发症。

Objective To explore the risk factors of atrial fibrillation(AF)in patients with hyperthyroidism.Methods From 755 patients diagnosed with hyperthyroidism in our hospital,we selected 112 cases with first AF seizure as the research group and another 112 cases without AF as the control group.We analyzed and compared the thyroid function indicators(FT3,FT4,TSH,TPOAB,TGAB and TRAB),cholesterin,triacylglycerol,past medical histories of hypertension,diabetes and smoking,inner diameter of left and right auricle(ventricle),ejection fraction,the maximum P-wave duration(P_(max)),and P-wave dispersion(PWD)between the two groups.Multivariate Logistic regression analysis of the above possible risk factors was performed.Results The indexes of FT3 and TSH,history of hypertension,inner diameter of left and right auricle,P_(max),and PWD vary significantly from the research group to the control group(P<0.05).Regression analysis results show that TSH,history of hypertension,inner diameter of left auricle and PWD are independent risk factors of AF in patients with hyperthyroidism.Conclusion For patients with hyperthyroidism complicating low TSH level,left atrial hypertrophy,increased PWD or history of hypertension,clinicians must keep high alert for the occurrence of AF and make early clinical interventions to reduce long-term complications.