饮酒对非瓣膜性心房颤动患者左心耳血栓形成的影响

Effect of alcohol intake on left atrial appendage thrombosis in patients with nonvalvular atrial fibrillation

目的探讨饮酒与非瓣膜性心房颤动(房颤)患者左心耳血栓形成的关系。方法连续入选2016年1月至2018年11月于贵州省人民医院拟行导管射频消融术的房颤患者436例,收集病史资料和实验室检查结果,并采用CHA2DS2-VASc评分进行卒中风险评估。通过经食管超声心动图判断有无左心耳血栓形成,并据此将患者分为血栓组(55例)和无血栓组(381例)。探讨饮酒与左心耳血栓形成的关系。结果436例非瓣膜性房颤患者中,55例(12.6%)存在左心耳血栓。血栓组患者饮酒比例均高于无血栓组(47.3%比12.1%,P<0.001)。logistic多因素回归分析结果显示,校正混杂因素后,年龄、非阵发性房颤、饮酒、房颤病程及CHA2DS2-VASc评分为房颤患者左心耳血栓形成的独立危险因素,其中饮酒为最强的独立危险因素(OR 14.673,95%CI 6.021~35.759,P<0.001)。结论饮酒是非瓣膜性房颤患者左心耳血栓形成的独立危险因素。

Objective To investigate the relationship between the alcohol intake and left atrial appendage(LAA)thrombosis in patients with nonvalvular atrial fi brillation(AF).Methods A total of 436 AF patients scheduled for catheter ablation from January 2016 to November 2018 in Guizhou Provincial People’s Hospital were enrolled continuously in this study,and the medical history and laboratory parameters were recorded.CHA2DS2-VASc score was used to measure the stroke risk.The patients were divided into thrombosis group(55 cases)and non-thrombosis group(381 cases)according to the results of LAA thrombosis,which was detected by transesophageal echocardiography.The relationship between the alcohol intake and LAA thrombosis was analyzed.Results Among all 436 patients with nonvalvular AF,55 cases(12.6%)had LAA.The proportion of drinking alcohol in thrombosis group was higher than that in non-thrombosis group(47.3%vs.12.1%,P<0.001).Multivariate logistic regression analysis showed that after adjustment for confounding factors,age,non-paroxysmal AF,alcohol intake,AF course,and CHA2DS2-VASc score were independent risk factors of LAA thrombosis,among which,alcohol intake was the strongest independent risk factor(OR 14.673,95%CI 6.021-35.759,P<0.001).Conclusions Alcohol intake is the independent risk factors for LAA thrombosis in nonvalvular AF patients.