风湿性心脏病住院患者心房颤动的研究

Study on Atrial Frbrillation in Hospitalized Patients with Rheumatic Heart Disease

① 目的:探究引起风湿性心脏病患者心房颤动的危险因素。② 方法:我们对2018年11月1日至2020年11月1日期间在青岛大学附属医院心外科确诊为风湿性心脏病的患者进行了一项回顾性病例对照研究。在396名患者中,共筛查出150名被纳入研究,根据患者的心电图将其分为窦性心律或心房颤动组并进行组间数据分析。③ 结果:风湿性心脏瓣膜病住院患者心房颤动的患病率为38.4%。风湿性心脏病单纯主动脉瓣膜病变的患者心房颤动的患病率是风湿性心脏病非单纯主动脉的混合瓣膜病变患者的0.072倍(比值比OR = 0.072,OR的95%置信区间:0.01~0.63),P值为0.018 【0.05有统计学意义。年龄、性别、合并冠状动脉粥样硬化性心脏病、下肢斑块形成、左心房内径(left atrial diameter, LA)、左心室舒张末期内径(left ventricular end-diastolic diameter, LVDd)及左心室收缩射血分数(left ventricular ejection fraction, LVEF)与风湿性心脏病患者获得心房颤动之间没有明显关联。④ 结论:心房颤动在风湿性心脏病住院患者中的患病率为38.4%,心房颤动的主要相关因素是非单纯主动脉瓣的联合瓣膜病变。

Objective: To explore the risk factors of atrial fibrillation in patients with rheumatic heart disease. Methods: A retrospective case-control study was conducted on patients diagnosed with rheumatic heart disease in the Department of Cardiology, Affiliated Hospital of Qingdao University from November 1, 2018 to November 1, 2020. Of the 396 patients screened, 150 were enrolled and assigned to sinus rhythm or atrial fibrillation based on their electrocardiogram and intergroup data were analyzed. Results: The prevalence of atrial fibrillation in hospitalized patients with rheumatic valvular heart disease was 38.4%. The prevalence of atrial fibrillation in patients with rheumatic heart disease with simple aortic valvular disease was 0.072 times higher than that in patients with rheumatic heart disease without simple aortic mixed valvular disease (ODDS ratio OR = 0.072, 95% confidence interval of OR: 0.01~0.63), and a P value of 0.018 <0.05 was statistically significant. Age, sex, coronary heart disease, lower limb plaque formation, left atrial diameter (LA), left ventricular end-diastolic diameter (LVDd), and left ventricular systolic ejection fraction (LVEF) were not significantly associated with atrial fibrillation in patients with rheumatic heart disease. Conclusion: The prevalence of atrial fibrillation in hospitalized patients with rheumatic heart disease was 38.4%, and the main factors related to atrial fibrillation were combined valvular disease with non-simple aortic valve.