外周血炎症因子与房颤患者生活质量的关联研究

Correlation between peripheral blood inflammatory factors and quality of life in patients with atrial fibrillation

目的调查房颤患者生活质量,探究外周血炎症因子与房颤患者生活质量的关联。方法连续纳入2013年12月至2015年7月在陆军军医大学第一附属医院心血管内科住院的新发非瓣膜性房颤患者258例。在患者初次住院时检测外周血常规炎症因子C反应蛋白(C-reactive protein,CRP)、血清白蛋白(albumin,ALB)、血小板淋巴细胞比值(platelet to lymphocyte ratio,PLR)、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、淋巴细胞单核细胞比值(lymphocyte to monocyte ratio,LMR)、D-二聚体(D-dimer),采用房颤生活质量量表(Atrial Fibrillation Effect on Quality of Life,AFEQT)收集患者生活质量数据,运用Spearman相关和偏相关分析外周血炎症因子与生活质量的关联。结果 230例完成房颤患者生活质量随访调查。不同年龄、性别、文化程度、吸烟史、饮酒史、他汀药物史、高血压史或糖尿病史等合并症的房颤患者生活质量总评分差异具有统计学意义(P<0.05)。Spearman相关分析发现D-二聚体与症状维度评分呈负相关(P<0.05),D-二聚体、NLR与日常活动评分及总评分呈负相关(P<0.05),LMR与日常活动评分及总评分呈正相关。偏相关分析调整混杂因素后,结果显示D-二聚体与房颤患者日常活动评分呈负相关(r=-0.136,P=0.044)。结论 D-二聚体水平升高的房颤患者日常活动能力较低,可能影响房颤患者的生活质量。

Objective To investigate the quality of life in patients with atrial fibrillation(AF)and to analyze its correlation with peripheral blood inflammatory factors.Methods A total of 258 patients with new-onset non-valvular AF who were admitted to the Department of Cardiology of the First Affiliated Hospital of Army Medical University from December 2013 to July 2015 were enrolled consecutively.The peripheral blood inflammatory factors,including C-reactive protein(CRP),albumin(ALB)and D-dimer,and platele to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR)and lymphocyte to monocyte ratio(LMR)were detected and calculated at admission.Atrial Fibrillation Effect on Quality of Life(AFEQT)questionnaire was adopted to assess the quality of life of these patients.Spearman correlation and partial correlation were used to analyze the correlation between peripheral blood inflammatory factors and quality of life.Results The correlation between the overall quality of life score and baseline variables such as age,gender,educational level,smoking,drinking,taking statins,history of hypertension or diabetes was statistically significant among the 230 patients who completed the questionaire about quality of life(P<0.05).Spearman correlation analysis showed that D-dimer was negatively correlated with symptom scores(P<0.05),and D-dimer and NLR were negatively while LMR positively correlated with daily activity scores and overall scores(P<0.05).After adjustiment of confounders,the partial correlation analysis represented a negative correlation between D-dimer and daily activity scores in the patients(r=-0.136,P=0.044).Conclusion Elevated D-dimer level suggests lower ability to perform daily activities in AF patients,and may affect their quality of life.