非体外循环冠状动脉搭桥术后新发房颤的影响因素分析

Influencing factors of new-onset atrial fibrillation after off-pump coronary artery bypass grafting surgery

目的:分析非体外循环冠状动脉搭桥(OPCABG)术后新发房颤的影响因素。方法:选取2019年1月—2019年8月择期行OPCABG术患者209例,术后住院期间确诊新发房颤患者36例(新发房颤组),未新发房颤患者173例(非房颤组)。比较两组患者的临床资料,进一步采用Logistic回归分析OPCABG术后新发房颤的影响因素。结果:新发房颤组右冠状动脉近段狭窄≥75%的比例、主动脉内球囊反搏(IABP)辅助率明显高于非房颤组(均P<0.05);两组间其他临床资料差异均没有统计学意义(均P>0.05);采用Logistic回归分析:右冠状动脉近段狭窄≥75%(OR=3.999,95%CI:2.072~19.753,P<0.001),IABP辅助率(OR=6.397,95%CI:2.072~19.753,P<0.001)是OPCABG术后新发房颤的影响因素。结论:右冠状动脉近段狭窄≥75%,围术期需要IABP辅助是OPCABG患者术后新发房颤的影响因素。

Objective:To analyze the influencing factors of new-onset atrial fibrillation after off-pump coronary artery bypass grafting(OPCABG)suryery.Methods:A total of 209 patients who underwent elective OPCABG surgery from January 2019 to August 2019 were selected.During postoperative hospitalization,36 patients(new-onset atrial fibrillation group)were diagnosed with new-onset atrial fibrillation,and 173 patients(non-new atrial fibrillation group)were not.Clinical data of the two groups were collected and compared and the influencing factors of new-onset atrial fibrillation after OPCABG surgery were analyzed by Logistic regression.Results:The rate of proximal stenosis of right coronary artery(more than 75%)and intra-aortic balloon pump(IABP)supporting the new-onset atrial fibrillation group were significantly higher than those in the non-new atrial fibrillation group,and the difference was statistically significant(all P<0.05).There was no statistically significant difference in other clinical data between the two groups(P>0.05).Logistic regression analysis showed that proximal stenosis of right coronary artery(more than 75%)(OR=3.999,95%CI:2.072-19.753,P<0.001)and IABP auxiliary rate(OR=6.397,95%CI:2.072-19.753,P<0.001)were the influencing factors for the new occurrence of atrial fibrillation after OPCABG surgery.Conclusion:The proximal stenosis of right coronary artery(more than 75%)and the need for IABP support during perioperative period are the influencing factors for the patients with new-onset atrial fibrillation after off-pump coronary artery bypass grafting surgery.