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|本期目录/Table of Contents|

心房颤动电复律的相关因素(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第6期
页码:
689-691
栏目:
临床研究
出版日期:
2007-12-20

文章信息/Info

Title:
Factors to predict whether electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation
作者:
胡小菁; 吕安林; 刁繁荣; 李军杰; 胡燕; 温俊娜; 孟晓雪; 宋延斌; 杜娟娟
第四军医大学西京医院心内科，陕西 西安 710032
Author(s):
HU Xiao-jing;  Lv An-lin; DIAO Fanrong; LI Jun-jie; HU Yan; WEN Jun-na; MENG Xiao-xue; SONG Yan-bin; DU Juan-juan
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, China
关键词:
房颤; 电复律; C反应蛋白
Keywords:
Atrial fibrillation;  Electrical cardioversion;  C reactive protein
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 分析影响心房颤动电复律成功的因素。方法 根据房颤患者62例电复律是否成功，分为复律成功组和失败组。比较两组在性别、年龄、并发冠心病、高血压病和瓣膜性心脏病、左心房内径、左心室舒张末期内径、左心室射血分数、C反应蛋白（CRP）水平的差异。CRP 检测：所有患者于入院后/入组后第2天常规空腹抽血, 采用免疫比浊法测定高敏感CRP (hs-CRP) 。结果 与转复成功组比较，转复失败组年龄大（P<0.05），左心房内径大（P<0.05），并发瓣膜性病变比例高（P<0.05），房颤持续时间长（P<0.05），hsCRP水平高（P<0.05）。经多因素分析，hs-CRP水平OR为2.1（95%CI 1.4-3.2,P<0.01）、左房直径OR为1.8（95%CI 1.2-2.2, P<0.01）和房颤持续时间OR为2.8(95%CI 1.6-4.0, P<0.01)。结论 hs-CRP、左房直径及房颤持续时间是影响房颤电复律成功的独立预测因素。
Abstract:
AIM To analyze the factors that predict whether the electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation. METHODS Sixtytwo patients with atrial fibrillation were divided into two groups according to the results of CV: successful cardioversion group and unsuccessful cardioversion group. The differences of gender, age, complications with coronary heart disease (CHD), hypertension, valvular heart disease (VHD), left atrial dimension (LAD), left ventricular enddiastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and preCV CRP levels of the two groups were analyzed. Serum specimens were collected in the second day after the patients were admitted into the hospital or enrolled in the study. High sensitivity Creactive protein was measured by latex particleenhanced immunoturbidimetric assay. RESULTS Compared with those in the successful cardioversion group, the age was older（P<0.05）, LAD was larger（P<0.05）, CRP level was and more patients had VHD（P<0.05）in unsuccessful cardioversion group. Multivariable analysis showed that CRP lever OR was 2.1（95%CI 1.4-3.2, P<0.01）, LAD OR was 1.8（95%CI 1.2-2.2,P<0.01） and the duration of AF OR was 2.8(95%CI 1.6-4.0, P<0.01). CONCLUSION Sensitive Creactive protein level, LAD and the duration of AF are independent factors to predict whether the electrical cardioversion can restore sinus rhythm in patients with atrial fibrillation.

参考文献/References

［1］ Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation［J］. Circulation, 1997,96(4): 1180-1184.

［2］ Cheruku KK, Ghani A, Ahmad F, et al. Efficacy of nonsteroidal antiinflammatory medications for prevention of atrial fibrillation following coronary artery bypass graft surgery［J］. Prev Cardio, 2004,7(1):13-18.

［3］ Korantzopoulos P, Kokkoris S. The antioxidant effects of statins may extend beyond ateriosclerosis: potential benefits for atrial fibrillation and heart failure［J］. Atherosclerosis, 2004,175(1):187.

［4］ Chung MK, Martin DO, Sprecher D, et al. Creactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation［J］. Circulation, 2001,104 (24):2886-2891.

［5］ Wazni O, Martin DO, Marrouche NF, et al. C reactive protein concentration and recurrence of atrial fibrillation after electrical cardioversion［J］. Heart, 2005,91(10):1303-1305.

［6］ Joseph FM, Ravi K, Faisal O, et al. High sensitivity Creactive protein: A novel predictor for recurrence of atrial fibrillation after successful cardioversion［J］. Coll Cardiology, 2005,46（7）:1284－1287.

［7］ Roijer A， Meurling CJ，Eskilsson J，et al． Left atrial appendage Outflow velocity index is superior to conventional criteria for prediction of maintenance of sinus rhythm after eardioversion．An echocardiographic study in patients with atrial fibrillation of a few months duration［J］．Seand Cardiovasc J，200l,35 (2):119-124.

［8］ Van Gelder IC, Crijns HJ, Van Gilst WH, et al. Prediction of uneventful cardioversion and maintenance of sinus rhythm from directcurrent electrical cardioversion of chronic atrial fibrillation and flutter［J］. Am J Cardiol, 1991,68 (1):41-46.

备注/Memo

备注/Memo:
收稿日期：2006-11-23.通讯作者：吕安林，副主任医师，博士，主要从事介入治疗心血管学研究 Email:lvanlin@fmmu.edu.cn 作者简介：胡小菁，主治医师，硕士生 Email :huxiaojing1002@tom.com
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