住院的原發(fā)性高血壓患者并發(fā)心房顫動的危險(xiǎn)因素分析
發(fā)布時(shí)間：2018-11-14 11:14
【摘要】：目的:探討住院的原發(fā)性高血壓(EH)患者并發(fā)心房顫動(AF)的獨(dú)立危險(xiǎn)因素。方法:以2016年1月1日至2016年6月30日在我院心血管內(nèi)科住院的2082例患者為研究對象來源,采用電子病歷查詢方式,收集患者資料并進(jìn)行回顧性的病例對照研究。最終收錄EH患者533例,按是否合并AF分為AF組74例、非AF組459例。對兩組患者的一般資料、臨床資料以及實(shí)驗(yàn)室、心臟超聲、胸部X線等檢查結(jié)果進(jìn)行比較分析,并運(yùn)用多因素Logistic回歸模型找出AF的獨(dú)立危險(xiǎn)因素。結(jié)果:1.兩組患者在年齡、高血壓年限、入院收縮壓、入院脈壓差、氨基末端B型利鈉肽前體(NT-proBNP)、血清白蛋白(ALB)、左房內(nèi)徑(LAD)、左室后壁厚度、左心室質(zhì)量指數(shù)、心胸比率上差異最顯著(P0.01),在紅細(xì)胞數(shù)目、血紅蛋白、紅細(xì)胞壓積、血清肌酐、室間隔厚度、左室射血分?jǐn)?shù)上的差異也有統(tǒng)計(jì)學(xué)意義(P0.05);2.兩組患者在性別、體重指數(shù)、即往收縮壓與舒張壓最高值、入院舒張壓、紅細(xì)胞分布寬度、血清尿素氮、血清尿酸、總膽固醇、甘油三酯、高密度脂蛋白-膽固醇、低密度脂蛋白-膽固醇、空腹血糖、左心室內(nèi)徑上無統(tǒng)計(jì)學(xué)意義(P0.05);3.多因素Logistic回歸分析顯示,LAD、NT-proBNP、年齡及高血壓年限是AF的獨(dú)立危險(xiǎn)因素,ALB是獨(dú)立保護(hù)因素;4.LAD的臨床應(yīng)用價(jià)值最大,以LAD=41.5mm為截值點(diǎn)來判斷有無AF的準(zhǔn)確率可以達(dá)到80.3%。結(jié)論:LAD、NT-proBNP、年齡及高血壓年限是AF的獨(dú)立危險(xiǎn)因素,其中以LAD的臨床應(yīng)用價(jià)值最大,取LAD=41.5mm來判斷有無AF的準(zhǔn)確率可以達(dá)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%.
【學(xué)位授予單位】：河南科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.11;R541.75
本文編號：2331007
[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%.
【學(xué)位授予單位】：河南科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.11;R541.75
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