住院的原发性高血压患者并发心房颤动的危险因素分析

发布时间：2018-11-14 11:14

【摘要】：目的:探讨住院的原发性高血压(EH)患者并发心房颤动(AF)的独立危险因素。方法:以2016年1月1日至2016年6月30日在我院心血管内科住院的2082例患者为研究对象来源,采用电子病历查询方式,收集患者资料并进行回顾性的病例对照研究。最终收录EH患者533例,按是否合并AF分为AF组74例、非AF组459例。对两组患者的一般资料、临床资料以及实验室、心脏超声、胸部X线等检查结果进行比较分析,并运用多因素Logistic回归模型找出AF的独立危险因素。结果:1.两组患者在年龄、高血压年限、入院收缩压、入院脉压差、氨基末端B型利钠肽前体(NT-proBNP)、血清白蛋白(ALB)、左房内径(LAD)、左室后壁厚度、左心室质量指数、心胸比率上差异最显著(P0.01),在红细胞数目、血红蛋白、红细胞压积、血清肌酐、室间隔厚度、左室射血分数上的差异也有统计学意义(P0.05);2.两组患者在性别、体重指数、即往收缩压与舒张压最高值、入院舒张压、红细胞分布宽度、血清尿素氮、血清尿酸、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、空腹血糖、左心室内径上无统计学意义(P0.05);3.多因素Logistic回归分析显示,LAD、NT-proBNP、年龄及高血压年限是AF的独立危险因素,ALB是独立保护因素;4.LAD的临床应用价值最大,以LAD=41.5mm为截值点来判断有无AF的准确率可以达到80.3%。结论:LAD、NT-proBNP、年龄及高血压年限是AF的独立危险因素,其中以LAD的临床应用价值最大,取LAD=41.5mm来判断有无AF的准确率可以达到80.3%。
[Abstract]:Objective: to investigate the independent risk factors of atrial fibrillation (AF) in hospitalized patients with essential hypertension (EH). Methods: from January 1, 2016 to June 30, 2016, 2082 patients who were hospitalized in our hospital from January 1, 2016 to June 30, 2016, were studied. The data of patients were collected by means of electronic medical records inquiry and a retrospective case-control study was conducted. Finally, 533 patients with EH were divided into AF group (74 cases) and non AF group (459 cases). The general data, clinical data, laboratory, cardiac ultrasound and chest X-ray findings of the two groups were compared and analyzed, and the independent risk factors of AF were found by multivariate Logistic regression model. The result is 1: 1. In both groups, age, duration of hypertension, systolic blood pressure (SBP), pulse pressure difference, amino-terminal B-type natriuretic peptide precursor (NT-proBNP), left atrial diameter of serum albumin (ALB), left ventricular posterior wall thickness (LAD), left ventricular mass index (LVMI), and left ventricular mass index (LVMI) were measured. The difference in cardiothoracic ratio was most significant (P0.01). There were significant differences in erythrocyte number, hemoglobin, hematocrit, serum creatinine, ventricular septal thickness and left ventricular ejection fraction (P0.05). 2. In both groups, the highest values of gender, BMI, systolic blood pressure and diastolic blood pressure, admission diastolic blood pressure, red blood cell distribution width, serum urea nitrogen, serum uric acid, total cholesterol, triglyceride, high density lipoprotein cholesterol, There was no significant difference in low density lipoprotein cholesterol, fasting blood glucose and left ventricular diameter (P0.05). 3. Multivariate Logistic regression analysis showed that age of LAD,NT-proBNP, and age of hypertension were independent risk factors for AF and ALB was an independent protective factor. The clinical application value of 4.LAD is the greatest. The accuracy rate of judging AF with LAD=41.5mm as cut-off point can reach 80.3%. Conclusion: age of LAD,NT-proBNP, and age of hypertension are independent risk factors of AF. The clinical value of LAD is the greatest, and the accuracy rate of judging AF by LAD=41.5mm can reach 80.3%.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.11;R541.75

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