阻塞性睡眠呼吸暂停低通气综合征对非瓣膜性心房颤动患者左心房血栓形成的影响

发布时间：2019-02-11 14:46

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对非瓣膜性心房颤动(房颤)患者左心房血栓形成的影响。方法回顾性分析2013年3月~2015年3月在郑州大学第一附属医院心血管内科拟行房颤射频消融术的非瓣膜性房颤患者,经食道心脏彩色多普勒超声(心脏彩超)检查确诊左心房是否有血栓形成分为两组,有左心房血栓形成作为试验组,无血栓患者作为对照组。收集患者的一般情况、合并疾病、心脏彩超指标、实验室检查指标等,比较两组患者各个指标的差异,并对差异有统计学意义的指标进行多因素Logistic回归分析。结果左心房有血栓患者共28例(占29.5%),与67例对照组相比,试验组患者合并OSAHS(75.0%vs.46.3%,P=0.011)、非阵发性房颤(持续性和长程持续性房颤)(67.9%vs.44.8%,P=0.015)和糖尿病(39.3%vs.11.9%,P=0.003)的比例更高,CHA2DS2-VASc评分[2(1,3)vs.1(1,2),P=0.016]、左心房内径[40(38,43)mm vs.37(34,40)mm,P=0.008]明显升高,差异有统计学意义。多因素Logistic回归分析结果显示OSAHS、糖尿病、CHA2DS2-VASc评分和左心房内径是非瓣膜性房颤患者左心房血栓形成的独立危险因素(OR分别为4.94、3.36、1.77、1.12,P均0.05)。结论非瓣膜性房颤患者左心房血栓形成不仅与糖尿病、左心房内径和CHA2DS2-VASc评分等传统的因素有关,也与OSAHS独立相关。
[Abstract]:Objective to investigate the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on left atrial thrombosis in patients with non-valvular atrial fibrillation (AF). Methods from March 2013 to March 2015, patients with non-valvular atrial fibrillation undergoing radiofrequency ablation of atrial fibrillation in Department of Cardiovascular Medicine, first affiliated Hospital of Zhengzhou University, were retrospectively analyzed. The left atrium thrombus was confirmed by color Doppler echocardiography (echocardiography) and divided into two groups: the experimental group with left atrial thrombosis and the control group with no thrombus. To collect the general situation of patients, combined disease, cardiac color Doppler index, laboratory index and so on, to compare the difference of each index between the two groups, and to carry on the multivariate Logistic regression analysis to the index which the difference has the statistical significance. Results there were 28 cases (29.5%) with left atrial thrombus. Compared with 67 cases of control group, the patients in the trial group were complicated with OSAHS (75.0 vs.46.3%). The rates of non-paroxysmal atrial fibrillation (persistent and long-term persistent atrial fibrillation) (67.9vs.44.8) and diabetes mellitus (39.3vs.11.9) were higher. CHA2DS2-VASc score [2 (1 / 3) vs.1 (1 / 2), P0. 016] and left atrial diameter [40 (38 / 43) mm vs.37 (34 / 40) mm,P=0.008] were significantly increased (P < 0. 016). Multivariate Logistic regression analysis showed that OSAHS, diabetes mellitus, CHA2DS2-VASc score and left atrial diameter were independent risk factors of left atrial thrombosis in patients with non-valvular atrial fibrillation (OR = 4.94 卤3.36 卤1.77 and 1.12, respectively). Conclusion left atrial thrombosis in patients with non-valvular atrial fibrillation is related not only to traditional factors such as diabetes mellitus, left atrial diameter and CHA2DS2-VASc score, but also to OSAHS.
【作者单位】：郑州大学第一附属医院心血管内科;
【分类号】：R766;R541.75

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