持续性房颤的影响因素考察(1)
[摘要]目的 探讨持续性房颤的相关危险因素并分析相关的临床意义。方法 选择2015年1月～2017年3月在我科住院的房颤患者169例，根据欧洲心血管病学会心律失常工作组(WGA-ESC)和北美起搏与电生理学会(NASPE)的临床分类方法分为阵发性房颤组(53例)和持续性房颤组(116例)，收集患者的一般资料、实验室检查和超声心动图检查结果等，用Logistic回归分析持续性房颤发生的危险因素。结果 两组患者的性别、年龄、吸烟和饮酒率以及高血压、糖尿病、冠心病患病率等比较，差异无统计学意义(P>0.05)。持续性房颤组患者的血尿酸(SUA)水平为(377.9±96.9)μmol/L，血B型脑钠肽前体(pro-BNP)水平为[1084.0(750.4，2238.3)] pg/ml，左心房内径(LAD)為(41.9±5.0)mm，均明显高于阵发性房颤组的(324.1±86.1)μmol/L、[175.3(99.0，529.7)] pg/ml、(35.8±5.0)mm，差异均有统计学意义(P<0.001)。逐步回归分析结果提示，SUA(OR=1.005，95%CI=1.001～1.010)、pro-BNP(OR=1.329，95%CI=1.000～1.001)以及LAD(OR=1.329，95%CI=1.199～1.475)是发生持续性房颤的危险因素(P<0.05)。结论 SUA、pro-BNP水平以及LAD，可能是持续性房颤发生的危险因素。
[关键词]心房颤动；尿酸；B型脑钠肽；左心房内径
[中图分类号] R541.75 [文献标识码] A [文章编号] 1674-4721(2018)4(c)-0051-04
Study of the risk factors related to permanent atrial fibrillation
ZHOU Huang YIN Yue-hui▲
Department of Cardiology，the Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
[Abstract]Objective To explore the risk factors related to permanent atrial fibrillation(AF) and discuss the clinical significance.Methods A total of 169 inpatients of our department with atrial fibrillation (AF) from January 2015 to March 2017 were consecutively enrolled in this study.They were divided into paroxysmal AF group (n=53) and permanent AF group (n=116) by the consensus of WGA-ESC and NASPE.The clinical data and the results of laboratory tests and ultrasound cardiograms were collected，risk factors of AF were analyzed by logistic regression analysis.Results There were no significant differences in gender，age，smoking，drinking，hypertension，diabetes or coronary heart disease between the two groups(P>0.05).However，the levels of SUA(324.1±86.1 vs. 377.9±96.9，P<0.001)，pro-BNP (175.3 [99.0，529.7] vs.1084.0 [750.4， 2238.3]，P<0.001)and LAD(35.8±5.0 vs. 41.9±5.0，P<0.001) were higher in permanent AF group rather than in paroxysmal group.The stepwise regression analysis results were showed，SUA (OR=1.005 [1.001-1.010]，P=0.027)，pro-BNP (OR=1.329 [1.000-1.001]，P=0.026) and LAD (OR=1.329 [1.199-1.475]，P=0.001) levels were the risk factors of the development of permanent AF.Conclusion The SVA，pro-BNP and LAD may bethe risk factors of the development of permanent AF.
[Key words]Atrial fibrillation；Uric acid；BNP；Left atrial diameter
心房颤动(房颤)是临床上常见的心律失常，可增加脑卒中、心力衰竭及痴呆的风险，并引起显著的致死率和致残率受到广泛关注[1]。房颤的危险因素包括年龄、男性、风湿性心脏病、高血压、充血性心力衰竭、甲状腺功能亢进、慢性肾脏疾病以及糖尿病[2-3]。而这些因素是否在不同类型的房颤中存在差异尚不明确。研究表明房颤的发病机制可能与炎症反应、氧化应激等有关[4-5]。尿酸是核酸中嘌呤在体内代谢的终末产物，生理状态下约有98%以尿酸钠形式存在血浆中，在生理浓度下发挥抗氧化作用，但在高尿酸血症状态下，尿酸则成为助氧化剂[6]。许多研究表明，高尿酸血症与房颤的发生有关[7-8]，而少有研究提及血尿酸水平与不同类型的房颤间的关系，本研究就性别、年龄等一般情况，血尿酸、B型脑钠肽前体等生化指标，以及左心房前后径等常见房颤危险因素是否在持续性房颤和阵发性房颤间存在差异进行探讨，现报道如下。, 百拇医药(周恍 殷跃辉)
[关键词]心房颤动；尿酸；B型脑钠肽；左心房内径
[中图分类号] R541.75 [文献标识码] A [文章编号] 1674-4721(2018)4(c)-0051-04
Study of the risk factors related to permanent atrial fibrillation
ZHOU Huang YIN Yue-hui▲
Department of Cardiology，the Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
[Abstract]Objective To explore the risk factors related to permanent atrial fibrillation(AF) and discuss the clinical significance.Methods A total of 169 inpatients of our department with atrial fibrillation (AF) from January 2015 to March 2017 were consecutively enrolled in this study.They were divided into paroxysmal AF group (n=53) and permanent AF group (n=116) by the consensus of WGA-ESC and NASPE.The clinical data and the results of laboratory tests and ultrasound cardiograms were collected，risk factors of AF were analyzed by logistic regression analysis.Results There were no significant differences in gender，age，smoking，drinking，hypertension，diabetes or coronary heart disease between the two groups(P>0.05).However，the levels of SUA(324.1±86.1 vs. 377.9±96.9，P<0.001)，pro-BNP (175.3 [99.0，529.7] vs.1084.0 [750.4， 2238.3]，P<0.001)and LAD(35.8±5.0 vs. 41.9±5.0，P<0.001) were higher in permanent AF group rather than in paroxysmal group.The stepwise regression analysis results were showed，SUA (OR=1.005 [1.001-1.010]，P=0.027)，pro-BNP (OR=1.329 [1.000-1.001]，P=0.026) and LAD (OR=1.329 [1.199-1.475]，P=0.001) levels were the risk factors of the development of permanent AF.Conclusion The SVA，pro-BNP and LAD may bethe risk factors of the development of permanent AF.
[Key words]Atrial fibrillation；Uric acid；BNP；Left atrial diameter
心房颤动(房颤)是临床上常见的心律失常，可增加脑卒中、心力衰竭及痴呆的风险，并引起显著的致死率和致残率受到广泛关注[1]。房颤的危险因素包括年龄、男性、风湿性心脏病、高血压、充血性心力衰竭、甲状腺功能亢进、慢性肾脏疾病以及糖尿病[2-3]。而这些因素是否在不同类型的房颤中存在差异尚不明确。研究表明房颤的发病机制可能与炎症反应、氧化应激等有关[4-5]。尿酸是核酸中嘌呤在体内代谢的终末产物，生理状态下约有98%以尿酸钠形式存在血浆中，在生理浓度下发挥抗氧化作用，但在高尿酸血症状态下，尿酸则成为助氧化剂[6]。许多研究表明，高尿酸血症与房颤的发生有关[7-8]，而少有研究提及血尿酸水平与不同类型的房颤间的关系，本研究就性别、年龄等一般情况，血尿酸、B型脑钠肽前体等生化指标，以及左心房前后径等常见房颤危险因素是否在持续性房颤和阵发性房颤间存在差异进行探讨，现报道如下。, 百拇医药(周恍 殷跃辉)