原发性高血压患者发生心房颤动的危险因素及其预测价值

Analysis of risk factors of essential hypertension with atrial fibrillation

目的探讨原发性高血压患者发生心房颤动的危险因素及其预测价值。方法选取2018年1月至2019年10月在安徽省第二人民医院心内科住院的原发性高血压患者共104例,根据患者有无心房颤动分为观察组(高血压合并房颤,38例)和对照组(高血压未合并房颤,66例),分别对两组一般资料(性别、年龄、高血压病程、吸烟饮酒史、家族史、糖尿病史)、血液生化指标[三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇(LDL-C)、尿酸、肌酐、尿素氮、血浆D二聚体、空腹血糖、纤维蛋白原、血红蛋白、同型半胱氨酸(HCY)]及心脏超声参数[左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、右心室内径(RVD)、左心室射血分数(LVEF)]进行单因素、多因素分析,同时通过受试者工作特征(ROC)曲线分析相关指标对此类患者并发心房颤动的预测价值。结果多因素logistic回归分析结果显示,LAD及LVPWT大、HCY高、LDL-C低是原发性高血压患者发生心房颤动的危险因素(P<0.05)。ROC曲线结果显示,LAD、LVPWT、HCY、LDL-C对原发性高血压患者发生心房颤动均具有一定的预测价值,4指标联合应用的预测价值最高[曲线下面积为0.831,95%CI:0.749~0.922]。结论LAD、LVPWT、HCY、LDL-C均为原发性高血压患者发生心房颤动的危险因素,4指标联合应用对此类患者并发心房颤动的预测价值较高。

Objective To explore the risk factors and predictivevalue of atrial fibrillation in patients with essential hypertension.Methods 104 patients were diagnosed primary hypertension from January 2018 to October 2019 in Cardiology Department of Second People’s Hospital of Anhui Province.Patients were divided into observation group(hypertension with atrial fibrillation,38 cases)and control group(hypertension with outatrial fibrillation,66 cases)according to whether they had atrial fibrillation.The general data of the two groups(sex,age,hypertension,the history of smoking,the history of smoking,family history,diabetes history),blood test biochemical index[triglyceride,total cholesterol,high,low density lipoprotein cholesterol(LDL-C),uric acid,Creatinine,urea nitrogen,plasma D dimer,fasting blood glucose,fibrinogen,hemoglobin,homocysteine(HCY)]and heart ultrasound parameters[left ventrom room(LAD),room thickness(IVST),left ventricular wall thickness(LVPWT),right the ventricular diameter(RVD),left ventricular ejection fractional(LVEF)]is performed on single factor analysis andmulti-factor regression analysis,at the same time,the ROC(recipient working characteristic curve)is used to analyze the predictive value of related indicators for such patients with atrial fibrillation.Results Multi-factor Logistic regression analysis show:Larger LAD and LVPWT,higher HCY,and lower LDL-C are risk factors for the onset of atrial fibrillation in essential hypertension(P<0.05).ROC analysis display:LAD,LVPWT,Hcy,LDL-Chave certain diagnostic value for primary hypertension with atrial fibrillation,the combined applicationof these four indicators has the highest diagnostic value[the area under the curve is 0.831,0.95%CI:0.749~0.922].Conclusions LAD,LVPWT,HCY,LDL-C are risk factors in primary hypertension,the combined application of these four indicators has a higher predictive value for such patients with atrial fibrillation.