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急性心肌梗死后新发心房颤动患者临床特征及危险因素

Clinical characteristics and risk factors of acute myocardial infarction with new atrial fibrillation

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目的 分析急性心肌梗死(AMI)后新发心房颤动(NOAF)患者的临床特征及危险因素.方法 选取2021年5月至2022年2月孝感市中心医院收治的230例AMI患者作为研究对象,根据AMI后NOAF的发生情况,将患者分为研究组(NOAF组,25例)和对照组(无NOAF,205例).收集两组患者的临床特征,如年龄、性别、吸烟史、高血压病史等;收集实验室检查结果,如肌钙蛋白I(CTNI)、脑钠肽(BNP)、C反应蛋白(CRP)、CRP与血清白蛋白的比值(CRA)等;收集影像学检查结果,如左房舒张末期内径(LAED)、左室舒张末期内径(LVEDD)等;采用多因素logistic回归分析AMI后NOAF的危险因素.结果 单因素分析结果显示,NOAF组和对照组患者的高血压病史比例、BNP、KILLIP分级、CRP、CRA、LAED比较,差异有统计学意义(P<0.05);多因素分析结果提示,BNP(β=1.423,OR=4.148,95%CI:1.139~15.099)、KILLIP 分级≥ Ⅱ 级(β=1.707,OR=5.515,95%CI:1.017~29.903)、CRP(β=2.096,OR=8.132,95%CI:1.541~42.895)、CRA(β=2.212,OR=9.136,95%CI:1.159~72.024)、LAED(β=2.472,OR=11.851,95%CI:2.571~54.619)是 AMI 后 NOAF 的危险因素(P<0.05,OR>1).结论 BNP、KILLIP 分级≥ Ⅱ 级、CRP、CRA、LAED是AMI后NOAF的危险因素.
Objective To analyze the clinical characteristics and risk factors of patients with acute myocardial infarction(AMI)with new-onset atrial fibrillation(NOAF).Methods A total of 230 patients with AMI admitted to Xiaogan Central Hospital from May 2021 to February 2022 were selected as the study objects.According to the occurrence of NOAF after AMI,the patients were divided into study group(25 cases in NOAF group)and control group(205 cases in without NOAF).Clinical characteristics of the two groups,such as age,gender,smoking history and hypertension history,were collected.The results of laboratory tests,such as cardiac troponin I(CTNI),brain natriuretic peptide(BNP),C-reactive protein(CRP),the ratio of CRP to serum albumin(CRA),etc.were collected.The results of imaging examinations includ-ing left atrial end-diastolic diameter(LAED)and left ventricular end-diastolic dimension(LVEDD)were collected.Mul-tivariate logistic regression was used to analyze the risk factors of NOAF after AMI.Results Univariate analysis showed that there were statistically significant differences in the proportion of hypertension history,BNP,KILLIP grade,CRP,CRA and LAED between NOAF group and control group,and the differences were statistically significant(P<0.05).Multivariate analysis results indicated that BNP(β=1.423,OR=4.148,95%CI:1.139~15.099),KILLIP ≥grade Ⅱ(β=1.707,OR=5.515,95%CI:1.017~29.903),CRP(β=2.096,OR=8.132,95%CI:1.541~42.895),CRA(β=2.212,OR=9.136,95%CI:1.159~72.024),LAED(β=2.472,OR=11.851,95%CI:2.571~54.619)were the risk factors for NOAF after AMI(P<0.05,OR>1).Conclusion BNP,KILLIP grade≥ Ⅱ,CRP,CRA and LAED are risk factors for AMI with NOAF.

Acute myocardial infarctionNew onsetAtri-al fibrillationRisk factors

陈硕、李朋、方梦、徐建辉

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武汉科技大学附属孝感医院孝感市中心医院心内二科,湖北孝感 432000

急性心肌梗死 新发 心房颤动 危险因素

2024

中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
年,卷(期):2024.31(17)