预激综合征合并房颤的影响因素分析

发布时间：2018-07-12 15:24

本文选题：预激综合征 + 显性旁路　；参考：《吉林大学》2016年硕士论文

【摘要】：目的:预激综合征患者合并心房颤动(房颤)时,快速心房率可经过显性旁路激动心室,引起快速的心室率甚至室颤,导致心脏骤停甚至心脏性猝死。本研究的目的主要是分析患者的临床状况以及房室旁路的特性与房颤发生的关系,为发现房颤的易感人群提供临床证据。方法:收集2010年2月1日到2015年10月1日在吉林大学第二附属医院心血管内科诊断为预激综合征并行心电生理检查和射频消融术的患者的病例资料,记录研究对象资料包括:姓名、性别、年龄、左房内径、左室舒张末内径、左室射血分数、吸烟、饮酒史、伴发疾病、房室旁路位置、数目、显性或隐匿性旁路等。患者心电生理检查中出现房颤或既往有房颤发作记录的定义为合并有房颤发作。统计学方法:患者计量资料采用均数±标准差表示,使用卡方检验分析两组数据的百分率,使用t检验(符合正态分布)或者秩和检验(不符合正态分布)分析两组数据的年龄、左房内径、左室舒张末径、左室射血分数等的均值,采用logistic回归分析对各影响因素进行相关性分析,所有的logistic回归分析结果采用比值比(OR)、95%可信区间(CI)、P值表述。P0.05具有统计学意义。结果:共计538例,其中合并房颤患者50例,无房颤患者488例。预激综合征合并房颤的患病率为9.29%,房颤组与无房颤组相比,卡方检验分析结果提示:男性、显性旁路、吸烟的患者发生房颤的较多,且差异具有统计学意义;两组患者发病年龄、饮酒史、房室旁路数量及位置、左房内径、左室舒张末内径、左室射血分数、合并高血压、糖尿病、冠心病、高脂血症人数比例差异无明显统计学意义。Logistic单因素回归分析提示:男性、吸烟、显性旁路为预激综合征合并房颤患者房颤发生的相关危险因素;Logistic多因素回归分析提示:男性、显性旁路为预激综合征合并房颤患者房颤发生的独立危险因素。结论:预激综合征患者中,房颤的患病率高于普通人群,年龄、饮酒史、房室旁路数量及位置、左房内径、左室舒张末内径、左室射血分数、伴发疾病等与房颤的发生无关,而男性、显性旁路增加房颤的发病风险,吸烟可能与房颤发生有关。
[Abstract]:Objective: in patients with preexcitation syndrome complicated with atrial fibrillation (AF), the rapid atrial rate can excite the ventricle via dominant bypass pathway, leading to rapid ventricular rate or even ventricular fibrillation, cardiac arrest or sudden cardiac death. The purpose of this study was to analyze the clinical status of patients and the relationship between the characteristics of atrioventricular accessory pathway and the occurrence of atrial fibrillation, and to provide clinical evidence for the susceptible population to find atrial fibrillation. Methods: from February 1, 2010 to October 1, 2015, we collected the data of patients diagnosed as preexcitation syndrome by electrophysiologic examination and radiofrequency ablation in the Department of Cardiovascular Medicine, the second affiliated Hospital of Jilin University, from February 1, 2010 to October 1, 2015. The data included: name, sex, age, left atrial diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, smoking, drinking history, associated diseases, position of atrioventricular accessory pathway, number of dominant or occult accessory pathways, etc. Atrial fibrillation in electrophysiologic examination is defined as accompanied by atrial fibrillation. Statistical method: the patient's measurement data were expressed as mean 卤standard deviation, and the percentage of the two groups of data were analyzed by chi-square test. The mean values of age, left atrial diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, and so on were analyzed by t test (consistent with normal distribution) or rank sum test (not consistent with normal distribution). Logistic regression analysis was used to analyze the correlation of the influencing factors. All the logistic regression results were expressed by the ratio (OR) 95% confidence interval (CI) P value. P05 was statistically significant. Results: a total of 538 patients, 50 patients with atrial fibrillation, 488 patients without atrial fibrillation. The prevalence of atrial fibrillation in patients with preexcitation syndrome and atrial fibrillation was 9.29. Compared with non-atrial fibrillation group, chi-square test showed that: male, dominant accessory pathway, smoking patients had more atrial fibrillation, and the difference was statistically significant. Age of onset, history of alcohol consumption, number and location of atrioventricular accessory pathway, left atrial diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, hypertension, diabetes, coronary heart disease, There was no significant difference in the proportion of hyperlipidemia. Logistic single factor regression analysis showed that: male, smoking, dominant bypass were risk factors of atrial fibrillation in patients with preexcitation syndrome and atrial fibrillation. Dominant accessory pathway is an independent risk factor for atrial fibrillation in patients with preexcitation syndrome and atrial fibrillation. Conclusion: the prevalence of atrial fibrillation in patients with preexcitation syndrome is higher than that in the general population, age, drinking history, number and location of atrioventricular accessory pathway, left atrial diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction and associated disease. In men, the dominant accessory pathway increases the risk of atrial fibrillation, and smoking may be associated with atrial fibrillation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.7

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