孤立性房颤与非孤立性房颤患者临床特征及二维超声心动图结果分析

doi:10.3969/j.issn.1006-7795.2018.06.026

摘要/Abstract

摘要： 目的分析孤立性房颤与非孤立性房颤患者临床特征及二维超声心动图相关数据，探究相应患者临床特点。方法本研究为单中心回顾性性研究。连续入选2016年1月至2018年1月于首都医科大学附属北京友谊医院就诊的年龄≤60岁的房颤患者159例，依据患者是否合并心肺疾病、高血压、糖尿病等疾病分为孤立性房颤与非孤立性房颤两组，探究二者临床特征及二维超声心动图结果差异。进一步将孤立性房颤患者依据左心房内径男性是否大于4.0 cm，女性是否大于3.8 cm，分为左心房增大组与左心房正常组进行对比分析，探究两组患者临床特征及二维超声心动图结果差异。并通过二分类Logistic回归进行进一步分析。结果孤立性房颤与非孤立性房颤两组相比，脑卒中发生率、左心室射血分数、左心室收缩末期内径、左心房内径等差异有统计学意义（P均<0.05），年龄、性别、左心室舒张末期内径等差异无统计学意义（P均>0.05）。进一步多因素Logistic回归分析表明，两组患者出现脑卒中事件差异无统计学意义（OR：3.781，95% CI：0.832~17.179，P=0.085）。孤立性房颤患者中左心房增大组与左心房正常组患者相比，年龄、左心室舒张末期内径、左心室收缩末期内径等差异有统计学意义（P均<0.05），性别、体质量指数、吸烟史、饮酒史、脑卒中病史、左心室射血分数、右心室内径、房颤持续时间、升主动脉内径等差异均无统计学意义（P均>0.05）。进一步多因素Logistic回归分析表明，两组患者年龄差异有统计学意义（OR：1.176，95% CI：1.007~1.372，P=0.040）。结论孤立性房颤患者与非孤立性房颤患者相比，左心房内径较小，左心室射血分数较高，脑卒中等心脑血管事件发生率较低，矫正后脑卒中事件差异无统计学意义。孤立性房颤男性发病率较高，患者年龄与左心房内径呈正相关，左心房内径增大与脑卒中事件无明显相关性。

关键词: 孤立性房颤, 非孤立性房颤, 二维超声心动图, 左心房

Abstract: Objective To explore the clinical features and transthoracic echocardiography results between lone atrial fibrillation and non-lone atrial fibrillation. Methods A total of 159 patients under 60 years old with atrial fibrillation who were admitted to Beijing Friendship Hospital,Capital Medical University from January 2016 to January 2018 were retrospectively collected. According to the existence of cardiopulmonary disease, hypertension, diabetes mellitus etc or not, patients were divided into lone atrial fibrillation group and non-lone atrial fibrillation group. According to whether male patients has a left atrium larger than 4.0 cm and female patients has a left atrium larger than 3.8 cm, lone atrial fibrillation group was further divided into normal left atrial group and left atrial dilated group to explore the clinical features and transthoracic echocardiography results between lone atrial fibrillation and non-lone atrial fibrillation and analysis the result with binary Logistic regression analysis. Results Lone atrial fibrillation compared with non-lone atrial fibrillation group, there were significant differences in the incidence of stroke, left ventricular ejection fraction, left ventricular end systolic diameter and left anteroposterior diameter (P<0.05), but there was no significant difference in age, sex, and left ventricular end diastolic diameter (P>0.05). Multivariate Logistic regression analysis showed that there was no significant difference in stroke events between the two groups (OR:3.781, 95% CI:0.832-17.179, P=0.085). There were significant differences in age, left ventricular end diastolic diameter and left ventricular end systolic diameter (P<0.05) in left atrial enlargement group and left atrial normal group in patients with lone atrial fibrillation. There were no significant differences in sex, body mass index, smoking history, drinking history, history of cerebral apoplexy, left ventricular ejection fraction, right ventricular diameter, atrial fibrillation duration and ascending aorta diameter (P>0.05). Multivariate Logistic regression analysis showed that the age difference between the two groups was statistically significant (OR:1.176, 95% CI:1.007-1.372, P=0.040). Conclusion Patients with lone atrial fibrillation have a small left atrial diameter and low risk of stroke but there was no significant difference in stroke events after correction. The incidence of male patients with lone atrial fibrillation is relatively high, and left atrial diameter is correlated with the age of the patients there is no significant relationship between left atrial diameter and stroke incidents.

Key words: lone atrial fibrillation, non-lone atrial fibrillation, cross-sectional echocardiography, left atrium

中图分类号:

R541

程丽婷, 高加勒, 原林皓, 吴永全. 孤立性房颤与非孤立性房颤患者临床特征及二维超声心动图结果分析[J]. 首都医科大学学报, 2018, 39(6): 945-949.

Cheng Liting, Gao Jiale, Yuan Linhao, Wu Yongquan. Analysis of clinical features and cross-sectional echocardiography of lone atrial fibrillation and non-lone atrial fibrillation patients[J]. Journal of Capital Medical University, 2018, 39(6): 945-949.

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