收缩压纵向轨迹与心房颤动的关系

发布时间：2019-05-24 16:27

【摘要】：目的:探讨收缩压(SBP)纵向轨迹与心房颤动(房颤)的关系。方法:以开滦研究中满足标准的对象组成研究队列。通过SAS Proc Traj程序确定观察对象2006~2007、2008~2009、2010~2011年健康体检的SBP纵向轨迹,生成5个不同的SBP轨迹组:低-稳定轨迹组、中-稳定轨迹组、中-高轨迹组、高-中轨迹组和高-稳定轨迹组。采用Log-Rank检验比较不同SBP轨迹组于2012~2013、2014~2015年2次健康体检时的房颤发病率的差异,采用多因素COX回归模型分析不同SBP轨迹组与房颤的关系。结果:(1)40 727例纳入研究,平均年龄(51.81±11.54)岁,其中,男性30 693例(75.4%)。低-稳定轨迹组10 950例,中-稳定轨迹组19 158例,中-高轨迹组3 736例,高-中轨迹组4 702例,高-稳定轨迹组2 181例。(2)低-稳定轨迹组、中-稳定轨迹组、中-高轨迹组、高-中轨迹组和高-稳定轨迹组房颤发病率分别为:0.1%、0.2%、0.5%、0.5%、0.6%(P均0.05)。(3)在多因素COX回归分析中,校正其他混杂因素后,与低-稳定轨迹相比,中-高轨迹、高-中轨迹、高-稳定轨迹均是新发房颤的危险因素,对应的HR(95%CI)分别为7.58(2.08~27.73)、5.30(1.88~14.95)、8.52(1.96~37.09)(P均0.05)。排除有心肌梗死病史、脑卒中病史者后,进行敏感性分析,结果与以上主要研究结果趋势一致。结论:SBP纵向轨迹水平升高是新发房颤的危险因素。
[Abstract]:Objective: To study the relationship between the longitudinal trajectory of systolic blood pressure (SBP) and atrial fibrillation (AF). Methods: The study cohort was composed of the subjects that met the criteria in the open-hand study. The SBP longitudinal track of the healthy physical examination in 2006-2007,2008-2009 and 2010-2011 was determined by the SAS Proc Traj procedure, and five different SBP track groups were generated: low-stable track group, medium-stable track group, medium-high track group, high-middle track group and high-stable track group. Using Log-Rank test to compare the incidence of atrial fibrillation in different SBP track groups from 2012 to 2013 and 2014 to 2015, a multi-factor COX regression model was used to analyze the relationship between different SBP track groups and atrial fibrillation. Results: (1)40 727 cases were included in the study, the mean age (51.81, 11.54) years, among which, there were 3,693 males (75.4%). In the low-stable track group, there were 10,950, middle-stable track group (19,158), middle-high locus group (3,736), high-middle track group (4,702), high-stable track group (2,181). (2) The incidence of AF was 0.1%, 0.2%, 0.5%, 0.5% and 0.6%, respectively (P <0.05). (3) In the multi-factor COX regression analysis, compared with the low-stable trajectory, the middle-high locus, high-middle locus and high-stable locus were the risk factors of new AF, and the corresponding HR (95% CI) was 7.58 (2.08-27.73), 5.30 (1.88-14.95), 8.52 (1.96-37.09) (P <0.05). The history of myocardial infarction and the history of stroke were excluded. After the history of stroke, the sensitivity analysis was performed, and the results were consistent with the results of the above main research results. Conclusion: The increase in the level of the longitudinal trajectory of SBP is a risk factor for new AF.
【作者单位】：华北理工大学附属开滦总医院心内二科;华北理工大学研究生院;华北理工大学附属医院超声科;
【分类号】：R541.75

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