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|本期目录/Table of Contents|

代谢综合征对冠心病患者心房纤颤的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第6期
页码:
884-886,890
栏目:
临床研究
出版日期:
2010-08-23

文章信息/Info

Title:
Relationship between metabolic syndrome and increased risk of atrial fibrillation in patients with coronary heart disease
作者:
李慧拓步雄李超民彭利静钟筱兰
解放军第四五一医院心血管内科,陕西 西安 710054
Author(s):
LI Hui TUO Bu-xiong LI Chao-min PENG Li-jing ZHONG Xiao-lan
Department of Cardiology, PLA 451 Hospital, Xi’an 710054, Shaanxi, China
关键词:
冠状动脉疾病代谢综合症心房颤动
Keywords:
coronary disease metabolic syndrome atrial fibrillation
分类号:
R5414;R541.7
DOI:
-
文献标识码:
A
摘要:
目的:探讨代谢综合征(MS)与冠心病患者心房纤颤(AF)发生的关系。方法: 入选住院拟行选择性冠状动脉造影(CAG),并确诊为冠心病(CHD)的患者1 805例,分为非MS组(n=1 150)及MS组(n=655),比较两组的相关临床资料,超声心动图及AF的情况。结果: MS组患者AF发生率明显高于非MS组(14.2% vs. 8.1%,P<0.01),MS组左房内经(LAD),左室舒张末期内径(LVEDD)、左室壁厚度(LVPW),左室质量(LVM),左室质量指数(LVMI)均高于非MS组(P<0.05),左室射血分数(LVEF)明显低于非MS组(P<0.01)。Logistic回归分析显示冠心病患者发生AF的危险与年龄,左房增大、左室扩大及并发MS明显相关(OR分别为1.666、4.446、1.950、1.636,均P<0.05)。AF(n=188)与无AF患者(n=1 617)相关指标、单因素分析发现AF组MS发生率明显高于无AF组(49.3% vs. 4.5%,P<0.01),体质量指数(BMI)、空腹血糖(FPG)水平明显升高(均P<0.05)。进一步Logistic回归分析显示MS组中肥胖与AF的发生关系最密切(OR:1.911,P<0.01)。结论: MS与冠心病患者发生AF的危险关系密切。
Abstract:
AIM: To explore the effect of metabolic syndrome (MetS) on atrial fibrillation (AF) in coronary heart disease (CHD) patients. METHODS: A cross-sectional study was conducted in a cohort of 1805 hospitalized CHD patients who were divided into CHD+non-MetS group (n=1 150) and CHD+MetS group (n=655) according to MetS criteria. RESULTS: Incidence of AF in CHD+MetS group was higher than that in CHD+non-MetS group (14.2% vs. 8.1%, P<0.01). Left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass (LVM) and left ventricular mass index (LVMI) were higher in CHD+MetS group than those in CHD+non-MetS group (P<0.05), whereas left ventricular ejection fraction (LVEF) was lower (P<0.01). After adjustment for age, LAD and LVEDD, logistic regression analysis showed that MetS predicted the incidence of AF in CHD patients (OR: 1.631, P<0.05). AF patients (n=188) were more likely to be complicated with MetS than non-AF patients (n=1 617, 49.3% vs. 34.5%, P<0.01) with higher body mass index (BMI) and fasting plasma glucose (FPG)(P<0.05). Further logistic regression analysis suggested that obesity was the most closely related independent predisposing risk factor for AF (OR: 1.911, P<0.01). CONCLUSION: MetS is closely associated with the incidence of AF in CHD patients. Obesity is the most closely related predisposing factor for AF among all MetS factors.

参考文献/References

[1]胡大一,孙艺红,周自强,等. 中国人非瓣膜性房颤脑卒中危险因素的病例对照研究[J]. 中华内科杂志, 2003,42(3):157-161.

[2]刘力生,龚兰生. 中国高血压防治指南(2005年修订版)[M]. 北京: 人民卫生出版社, 2006,1-53

[3] Wijffels MC, kiredhhof CJ, Dorland R, et al. Atrial fibrillation begets atrial fibrillation: a study in awake chronically instrumented goats[J]. Circulation, 1995, 92(7):1954-1968.

[4]Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation[J]. JAMA, 2004, 292(20):2471-2477.

[5]Dublin S, French B, Glazer NL, et al. Risk of new-onset atrial fibrillation in relation to body mass index[J]. Arch Intern Med, 2006, 166(21):2322-2328.

[6] Movahed MR, Hashemiadeh M, Jamal MM. Diabetes mellitus is a strong,independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease[J]. Int J Cardiol, 2005, 105(3):315-318.

[7]Watanabe H, Tanabe N, Watanabe T, et al. Metabolic syndrome and risk of dependent of atrial fibrillation: The Niigata Preventive Medicine study[J]. Circulation, 2008, 117(10):1255-1260.

[8]刘艳,曲鹏,张云,等.代谢综合征对高血压患者左室肥厚的影响[J]. 中华高血压杂志, 2008, 16(1):70-73.

[9] Cohen M, Naccarelli GV. Pathophysiology and disease progression of atrial fibrillation: importance of achieving and maintaining sinus rhythm[J]. J Cardiovasc Eleetrophysiol, 2008,19(8):885-890.

[10]段菊花,谢志泉. 代谢综合征交感神经系统兴奋性增高的机制[J]. 临床心血管病杂志, 2008, 24(8):562-563.

[11]Landsberg L.Insulin-mediated sympathetic stimulation: role in the Pathogenesis of obesity-related hapertension (or, how insulin affects blood pressure, and why)[J]. J Hypertens, 2001, 19(3 Pt 2):523-528.

[12]Brilla CG, Zhou G, Matsubara L, et al. Collagen metabolism in cultured adult rat cardiac fibroblasts: response to angiotensin II and aldosterone[J]. J Mol Cell Cardiol, 1994, 26(7):809-820.

[13]Zou Y, Komuro I, Yamazaki T, et al. Cell type-specific angiotensin II-evoked signal transduction. Pathways critical roles of Gbetaganma. Subunit, Src family, and Ras in cardiol fibroblasts[J]. Circ Res, 1998, 82(3):337-345.

[14]Nakashima H, Kumagai K, Urata H, et al. Angiotensin II antagonist prevents electrical remodeling in atrial fibrillation[J]. Circulation, 2000, 101(22):2612-2617.

[15]陈璐璐. 代谢综合征—存在的意义和困惑[J]. 临床心血管病杂志, 2008, 24(6):402-403.

备注/Memo

备注/Memo:
收稿日期:2008-09-02.作者简介:李慧,副主任医师,硕士生Email:lit-mouse@163.com
更新日期/Last Update: 2010-08-22