【摘要】：目的探討阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)對(duì)非瓣膜性心房顫動(dòng)(房顫)患者左心房血栓形成的影響。方法回顧性分析2013年3月~2015年3月在鄭州大學(xué)第一附屬醫(yī)院心血管內(nèi)科擬行房顫射頻消融術(shù)的非瓣膜性房顫患者,經(jīng)食道心臟彩色多普勒超聲(心臟彩超)檢查確診左心房是否有血栓形成分為兩組,有左心房血栓形成作為試驗(yàn)組,無血栓患者作為對(duì)照組。收集患者的一般情況、合并疾病、心臟彩超指標(biāo)、實(shí)驗(yàn)室檢查指標(biāo)等,比較兩組患者各個(gè)指標(biāo)的差異,并對(duì)差異有統(tǒng)計(jì)學(xué)意義的指標(biāo)進(jìn)行多因素Logistic回歸分析。結(jié)果左心房有血栓患者共28例(占29.5%),與67例對(duì)照組相比,試驗(yàn)組患者合并OSAHS(75.0%vs.46.3%,P=0.011)、非陣發(fā)性房顫(持續(xù)性和長(zhǎng)程持續(xù)性房顫)(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評(píng)分[2(1,3)vs.1(1,2),P=0.016]、左心房?jī)?nèi)徑[40(38,43)mm vs.37(34,40)mm,P=0.008]明顯升高,差異有統(tǒng)計(jì)學(xué)意義。多因素Logistic回歸分析結(jié)果顯示OSAHS、糖尿病、CHA2DS2-VASc評(píng)分和左心房?jī)?nèi)徑是非瓣膜性房顫患者左心房血栓形成的獨(dú)立危險(xiǎn)因素(OR分別為4.94、3.36、1.77、1.12,P均0.05)。結(jié)論非瓣膜性房顫患者左心房血栓形成不僅與糖尿病、左心房?jī)?nèi)徑和CHA2DS2-VASc評(píng)分等傳統(tǒng)的因素有關(guān),也與OSAHS獨(dú)立相關(guān)。
[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 鹵3.36 鹵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.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院心血管內(nèi)科;
【分類號(hào)】：R766;R541.75

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