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目的探讨冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素。方法连续收集中国人民解放军总医院2011年1月至2012年12月入院治疗的冠状动脉粥样硬化性高血压患者,对其心房颤动发生的危险因素进行回顾性研究。按照收缩压≥140 mm Hg(1 mm Hg=0.133 kPa)或舒张压≥90 mm Hg定义为高血压患者,采用单因素及Logistic回归模型分析冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素。结果 3990例冠状动脉粥样硬化患者符合标准入选,其中137例并发心房颤动,心房颤动发生率为3.4%。动脉粥样硬化并发心房颤动组较单纯动脉粥样硬化组年龄更大(P<0.01)、心率更快(P<0.01)、吸烟者更少(P=0.021)、饮酒者更少(P=0.035);超声心动图检查结果显示左心室收缩末容量更大(P<0.01),左心室舒张末容量更大(P<0.01),左心室收缩末内径更大(P<0.01),左心室舒张末内径更大(P<0.01),左心室射血分数更小(P<0.01),左心房前后径更大(P<0.01),缩短分数更小(P<0.01);生化检测血钾浓度更高(P=0.014)。多因素Logistic回归分析冠状动脉粥样硬化性高血压患者发生心房颤动的危险因素,发现年龄(OR=1.033,P=0.001)、左心房前后径(OR=1.183,P=0.000)是其发生的独立危险因素。结论年龄、左心房前后径是冠状动脉粥样硬化性高血压患者发生心房颤动的独立危险因素。
Objective To investigate the risk factors of atrial fibrillation in patients with coronary atherosclerosis hypertension. Methods The patients with coronary atherosclerotic hypertension admitted from January 2011 to December 2012 in Chinese PLA General Hospital were retrospectively studied for the risk factors of atrial fibrillation. Hypertensive patients were defined as systolic BP ≥140 mm Hg (1 mm Hg = 0.133 kPa) or diastolic BP ≥90 mm Hg. Univariate and Logistic regression models were used to analyze the risk of atrial fibrillation in patients with coronary atherosclerosis factor. Results A total of 3990 patients with coronary atherosclerosis were included in the criteria. Of the 137 patients with atrial fibrillation, the incidence of atrial fibrillation was 3.4%. Patients with atherosclerotic atrial fibrillation had greater age (P <0.01), faster heart rate (P <0.01), fewer smokers (P = 0.021), and fewer drinkers (P = 0.035). The results of echocardiography showed that left ventricular end systolic volume (P <0.01), left ventricular end diastolic volume (P <0.01), left ventricular end-systolic diameter (P <0.01) (P <0.01), smaller left ventricular ejection fraction (P <0.01), larger anteroposterior diameter of left anterior chamber (P <0.01), smaller shortening fraction (P <0.01), and biochemical detection of serum potassium Higher concentrations (P = 0.014). Multivariate Logistic regression analysis of risk factors for atrial fibrillation in patients with coronary atherosclerosis found that age (OR = 1.033, P = 0.001), anteroposterior diameter of left anterior chamber (OR = 1.183, P = 0.000) Independent risk factors. Conclusion Age and left atrium anteroposterior diameter are independent risk factors of atrial fibrillation in patients with coronary atherosclerosis.