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|本期目录/Table of Contents|

阵发性房颤随访情况和阵发性房颤进展的危险因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第2期
页码:
182-184,188
栏目:
临床研究
出版日期:
2018-02-15

文章信息/Info

Title:
Follow-up of paroxysmal atrial fibrillation and predictors of atrial fibrillation progression
作者:
赵 君; 谭强; 张双月; 邹晓译; 郝 佳; 孙 强; 张 扬; 丁立君
（河北医科大学附属秦皇岛市第一医院心脏内科，河北 秦皇岛 066000）
Author(s):
ZHAO Jun;  TAN Qiang;  ZHANG Shuang-yue;  ZOU Xiao-yi;  HAO Jia;  SUN Qiang;  ZHANG Yang;  DING Li-jun
(Department of Cardiology, first hospital of Qinhuangdao, Qinhuangdao 066000 , Hebei, China)
关键词:
阵发性房颤; 房颤进展; 超敏C反应蛋白; CHADS2评分
Keywords:
paroxysmal atrial fibrillation;  atrial fibrillation progression;  C-reactive protein;  CHADS2 score
分类号:
R245
DOI:
-
文献标识码:
A
摘要:
目的 观察阵发性房颤的随访情况和分析阵发性房颤进展的危险因素。方法 对216例阵发性房颤患者进行随访，观察其主要结局（是否发生房颤进展）和临床事件（卒中、心力衰竭、再住院和出血事件），再按是否房颤进展分为房颤进展组（n=87）和房颤未进展组（n=129）。采用巢式病例对照研究方法，进行单因素分析和多因素分析（采用多因素Logistic回归模型），分析影响房颤进展的危险因素。结果 216例阵发性房颤患者经过3.45年（中位数）随访发生房颤进展者87例，其发生进展率为40.2%，年进展率为11.7%。房颤进展组脑卒中、心力衰竭、房颤相关的再住院发生率均显著高于房颤未进展组（分别17% vs. 6%,18% vs. 5%,37% vs. 17%, 分别P<0.05，P<0.01和P<0.01）；两组间病死率及出血发生率差异未达到显著水平。多因素分析显示，年龄(OR 1.082,95%CI 1.016-1.392,P<0.05)、左房内径>45 mm(OR 2.339,95%CI 1.445-3.785,P<0.05)、CHADS2评分>3分(OR 1.382,95%CI 1.081-1.987,P<0.05)以及超敏C反应蛋白（hs-CRP）水平(OR 1.124,95%CI 1.005-2.345,P<0.05 )是房颤进展的独立危险因素。结论 阵发性房颤进展的年发生率为11.6%。影响房颤进展的独立危险因素为年龄、左房内径、hs-CRP水平及CHADS2评分。
Abstract:
AIM The aim of this study was to explore follow-up events in patients with paroxymal atrial fibrillation (AF) and to analyze risk factors which influence AF progression. METHODS A total of 216 patients with paroxysmal AF were retrospective analyzed. In the present investigation, there was observation of the main endpoint (AF progression) and clinical events, including stroke, cardiac dysfunction, rehospitalization, and bleeding. Patients were divided into paroxysmal AF group (n=87) and AF progression group (n=129). Nested case-control study was used for univariate and multivariate analysis (logistic regression model) to explore risk factors which influnence AF progression. RESULTS 87 patients with paroxysmal AF progressed to persistent AF or permanent AF during follow-up period (3.45 years, median). The totle rate of AF progression was 40.2% and the annual rate was 11.7%. AF progression group had higher rate of stroke, cardiac dysfunction, and rehospitalization (17% vs. 6%, 18% vs. 5%, 37% vs. 17%, P<0.05, P<0.01, P<0.01). There were no statistical differences of death and bleeding (P>0.05). Multivariate analysis showed that age (OR 1.082, 95%CI 1.016-1.392, P<0.05), LAD>45 mm (OR 2.339, 95%CI 1.445-3.785, P<0.05). CHADS2 score>3 (OR 1.382, 95%CI 1.081-1.987, P<0.05) and hs-CRP (OR 1.124, 95%CI 1.005-2.345, P<0.05) were independent risk factors to predict AF progression. CONCLUSION Age, LAD>45 mm, CHADS2 score>3 and level of hs-CRP are independent risk factors to predict AF progression.

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备注/Memo

备注/Memo:
收稿日期：2017-04-09.作者简介：赵君，主治医师，硕士生 Email：feiyangfirst@sina.com
更新日期/Last Update: 1900-01-01