直接胆红素与非瓣膜病心房颤动类型的相关性分析

Correlation Analysis Between Direct Bilirubin and Types of Atrial Fibrillation in Non-valvular Disease

目的探讨直接胆红素与非瓣膜病心房颤动类型的相关性。方法选取2015年1月~2019年1月在我院住院的非瓣膜病房颤患者337例,其中阵发性房颤患者234例为阵发房颤组,持续性及永久性房颤患者103例为慢性房颤组,比较两组临床资料,采用Spearman相关及二分类Logistic回归模型分析直接胆红素与房颤类型的关系。结果慢性房颤组男性比例、体重、尿酸、总胆红素、直接胆红素、左房直径、左室舒张末内径、右房直径、右室舒张末内径高于阵发性房颤组,LVEF低于阵发性房颤组,差异有统计学意义(P<0.05);两组年龄、身高、白细胞计数、红细胞计数、血红蛋白、血小板计数、D-二聚体、肌酐、TC、TG、LDL、谷丙转氨酶、TSH、TT3、TT4、BNP、高血压史、糖尿病史、吸烟史、饮酒史比较,差异无统计学意义(P>0.05)。Spearman相关性分析显示,体重、尿酸、总胆红素、直接胆红素、左房内径、左室舒张末内径、右房内径及右室舒张末内径与慢性房颤之间呈正相关(r=0.133、0.178、0.193、0.225、0.470、0.122、0.390、0.294,P<0.05),左室射血分数与慢性房颤呈负相关(r=-0.216,P<0.05)。二分类Logistic回归模型分析显示,左房内径与慢性房颤独立相关,直接胆红素未进入回归方程。结论直接胆红素与非瓣膜病心房颤动类型无独立相关性,心房体积增大是阵发房颤进展为慢性房颤的独立危险因素。

Objective To investigate the correlation between direct bilirubin and the types of non-valvular atrial fibrillation.Methods A total of 337 patients with non-valvular atrial fibrillation who were hospitalized in our hospital from January 2015 to January 2019 were selected.Among them,234 patients with paroxysmal atrial fibrillation were included in the paroxysmal atrial fibrillation group.103 patients with persistent and permanent atrial fibrillation belong to the chronic atrial fibrillation group.The clinical data of the two groups were compared,and the Spearman correlation and binary Logistic regression model were used to analyze the relationship between direct bilirubin and the type of atrial fibrillation.Results The proportion of men in the chronic atrial fibrillation group,body weight,uric acid,total bilirubin,direct bilirubin,left atrial diameter,left ventricular end diastolic inner diameter,right atrial diameter,and right ventricular end diastolic inner diameter were higher than those in paroxysmal atrial fibrillation group.LVEF was lower than paroxysmal atrial fibrillation group,the difference was statistically significant(P<0.05);Two groups of age,height,white blood cell count,red blood cell count,hemoglobin,platelet count,D-dimer,creatinine,TC,TG,LDL,alanine aminotransferase,TSH,TT3,TT4,BNP,history of hypertension,history of diabetes,there was no statistically significant difference between smoking history and drinking history(P>0.05).Spearman correlation analysis showed that body weight,uric acid,total bilirubin,direct bilirubin,left atrial diameter,left ventricular end diastolic diameter,right atrial diameter and right ventricular end diastolic diameter were positively correlated with chronic atrial fibrillation(r=0.133,0.178,0.193,0.225,0.470,0.122,0.390,0.294,P<0.05),left ventricular ejection fraction was negatively correlated with chronic atrial fibrillation(r=-0.216,P<0.05).The analysis of the binary Logistic regression model showed that the left atrial diameter was independently related to chronic atrial fibrillation,and the direct bilirubin did not enter the regression equation.Conclusion There is no independent correlation between direct bilirubin and the types of non-valvular atrial fibrillation.Increased atrial volume is an independent risk factor for the progression of paroxysmal atrial fibrillation to chronic atrial fibrillation.