慢性高原性心脏病患者非瓣膜性房颤的临床特征和危险因素分析

Clinical characteristics and risk factors of atrial fibrillation in patients with chronic high altitude heart disease

目的:分析高原地区慢性高原性心脏病患者非瓣膜性心房颤动(房颤)的临床特征和危险因素。方法:连续纳入2021年8月—2022年6月入住西藏山南市人民医院心内科的慢性高原性心脏病患者共303例,分为房颤组(83例)和非房颤组(220例)。比较基线资料,采用相关分析和logistic回归分析房颤的相关因素和危险因素。结果:房颤与年龄、血尿酸、N末端B型利钠肽原(NT-proBNP)、左房内径、右室内径均呈正相关(r=0.3114、0.1415、0.2452、0.1214、0.5925,均P<0.05),与低密度脂蛋白胆固醇、血红蛋白、左室射血分数均呈负相关(r=-0.1271、-0.1347、-0.1827,均P<0.05)。多因素回归分析显示,年龄(OR=1.074,95%CI:1.039~1.109,P<0.05)、血尿酸(OR=1.003,95%CI:1.000~1.005,P=0.032)及左房增大(OR=1.312,95%CI:1.219~1.413,P<0.05)是房颤的独立危险因素。结论:年龄、血尿酸及左房增大为慢性高原性心脏病患者房颤发生的危险因素。

Objective: To analyze the clinical characteristics and risk factors of atrial fibrillation(AF) in patients with chronic high altitude heart disease. Methods: The present study enrolled 303 consecutive patients with chronic high altitude heart disease who received hospitalization in our center. The patients were divided into AF group(83 cases) and non-AF group(220 cases). Data of clinical characteristics and related laboratory tests were collected and analyzed. We conducted Lasso-Logistic regression for dimension reduction and feature selection, and then identified risk factors for AF in chronic high altitude heart diseases. Results: The AF was positively correlated with age, serum uric acid, NT-proBNP, left atrial dimension, right ventricle dimension(r=0.3114, 0.1415, 0.2452, 0.1214, 0.5925, all P<0.05), and AF was negatively correlated with low density lipoprotein, hemoglobin, left ventricular ejection fraction(r=-0.1271,-0.1347,-0.1827, all P<0.05) in patients. The Logistic regression revealed that age(OR=1.074, 95%CI: 1.039-1.109), serum uric acid(OR=1.003, 95%CI: 1.000-1.005) and enlarged left atrial dimension(OR=1.312, 95%CI: 1.219-1.413) were the risk factors of AF in patients with chronic high altitude heart diseases(all P<0.05). Conclusion: Age, serum uric acid and enlarged left atrial dimension are risk factors of AF in Chronic high altitude heart diseases.