摘要
目的 探讨心房颤动(简称:房颤)分型与女性非瓣膜性房颤患者的关系.方法 回顾性分析 2019 年 10 月至2022 年2 月在贵州省人民医院心内科住院的女性非瓣膜性房颤患者 305 例,收集患者临床基线资料和辅助检查结果.根据经食管超声心动图结果,将纳入研究的患者分为左心耳无血栓组260 例和左心耳血栓组45 例.比较两组患者基线资料,运用Logistic回归分析探讨女性非瓣膜性房颤患者合并左心耳血栓形成的预测因素.结果 共纳入 305 例女性非瓣膜性房颤患者,其中45 例(15%)存在左心耳血栓.两组间年龄、左心室射血分数(LVEF)、血浆纤维蛋白原浓度(Fbg)和高血压、冠状动脉粥样硬化性心脏病、血管疾病、脑卒中占比的差异均无统计学意义(P>0.05).左心耳血栓组患者的房颤病程、CHA2DS2-VASc评分、左房内径(LAD)、左心室舒张末期内径(LVEDD)、B型脑钠肽(BNP)、血肌酐(SCr)和非阵发性心房颤动、2 型糖尿病、心力衰竭的占比均大于左心耳无血栓组(P<0.05),左心耳血栓组患者中合并糖尿病、心力衰竭的例数均小于左心耳无血栓组(P<0.05).调整混杂因素后,非阵发性房颤为女性非瓣膜性房颤患者合并左心耳血栓形成的独立预测因素(OR =0.252,95%CI 0.114～0.557,P =0.001).结论 非阵发性房颤是女性非瓣膜性房颤患者左心耳血栓形成的独立预测因素.
Abstract
Objective To investigate the relationship between the type of atrial fibrillation(AF)and the formation of left atrial thrombus in female patients with non-valvular AF.Methods A total of 305 female patients with non-valvular atrial fibrillation who were hospitalized in the department of cardiology of Guizhou Provincial People's Hospital from October 2019 to February 2022 were retrospectively analyzed.The clinical baseline data and auxiliary examination results of the patients were collected.According to the results of transesophageal echocardiography,the patients included in the study were divided into the left atrial appendage without thrombosis group(n =260)and the left atrial appendage with thrombosis group(n =45).The baseline data of the two groups were compared,and Logistic regression analysis was used to explore the predictive factors of left atrial appendage thrombosis in female pa-tients with non-valvular atrial fibrillation.Results A total of 305 female patients with non-valvular AF were included,45 of them(15%)had left atrial thrombus.There were no significant differences in age,left ventricular ejection fraction(LVEF),plasma fi-brinogen concentration(Fbg),and the proportion of hypertension,coronary atherosclerotic heart disease,vascular disease,and stroke between the two groups(P>0.05).The duration of AF,CHA2DS2-VASc score,left atrial diameter(LAD),left ventricular end-di-astolic diameter(LVEDD),B-type natriuretic peptide(BNP),serum creatinine(SCr),and the proportion of non-paroxysmal AF,type 2 diabetes,and heart failure in the left atrial thrombus group were higher than those in the left atrial no thrombus group(P<0.05),while the proportion of patients with diabetes and heart failure in the left atrial thrombus group was lower than that in the left atrial no thrombus group(P<0.05).After adjusting for confounding factors,non-paroxysmal AF was an independent predictor of left atrial thrombus formation in female patients with non-valvular AF(OR =0.252,95%CI 0.114～0.557,P =0.001).Conclu-sion Non-paroxysmal AF is an independent predictor of left atrial thrombus formation in female patients with non-valvular AF.
基金项目
北京市医院管理中心青年人才培养"青苗"计划(QML20212201)
维普
万方数据