急性心肌梗死合并心房颤动患者的临床特点分析
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(1.湖北中医药大学中医临床学院,湖北省武汉市 430065;2.华中科技大学同济医学院附属协和医院心内科, 湖北省武汉市 430022;3.武汉市第四医院心内科,湖北省武汉市 430033;4.华中科技大学同济医学院 附属武汉中心医院药学部,湖北省武汉市 430014)

作者简介:

邱静,博士研究生,研究方向为中医药防治心脑血管疾病,E-mail为748053231@qq.com。通信作者苏冠华,博士,副主任医师,研究方向为冠心病和心力衰竭的基础与临床,E-mail为suguanhua@163.com。

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基金项目:

国家自然科学基金资助项目(81700345、81600317);湖北省生物靶向治疗研究重点实验室基金项目(02.03.2014-10)


Investigation of clinical characteristics in acute myocardial infarction patients with atrial fibrillation
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1.Clinical College of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China;2.Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China;3.Department of Cardiology, Wuhan Fourth Hospital, Wuhan, Hubei 430033, China;4.Department of Pharmacy, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China)

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    摘要:

    目的 探讨急性心肌梗死(AMI)合并心房颤动(AF)患者的临床特点。方法 纳入2014年1月至2017年12月华中科技大学同济医学院附属协和医院心内科收治的AMI住院患者777例。根据患者既往史及住院期间心电图诊断是否合并AF,将其分为AMI并AF组(78例)和AMI无AF组(699例)。收集2组患者的基本情况、心血管危险因素、生物化学指标、心脏超声、冠状动脉造影等资料,进行统计分析,比较2组患者临床特点的差异。结果 AMI并AF组患者的年龄、吸烟史、卒中史、慢性肾脏病史、室性心律失常的发生率均显著高于AMI无AF组(P<0.05)。AMI并AF组血红蛋白、红细胞计数、甘油三酯、估算的肾小球滤过率显著低于AMI无AF组,而血尿酸、尿素氮、肌酐、胱抑素C、脑钠尿肽、高敏C反应蛋白水平均显著高于AMI无AF组(P<0.05)。心脏超声结果显示,与AMI无AF组相比,AMI并AF组左心房内径和右心房内径明显增大(P<0.01),左心室射血分数显著降低(P<0.05)。2组冠状动脉造影检查结果无显著差异(P>0.05)。结论 AMI合并AF患者室性心律失常、心力衰竭发生率高,易合并贫血及慢性肾脏病。

    Abstract:

    Aim To investigate the clinical characteristics of acute myocardial infarction (AMI) patients with atrial fibrillation (AF). Methods From January 2014 to December 7,7 AMI inpatients admitted to the Department of Cardiology of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were enrolled. According to the patient's previous history and electrocardiogram diagnosis during hospitalization, the patients were divided into AMI with AF group (78 cases) and AMI without AF group (699 cases). The basic information, cardiovascular risk factors, biochemical indicators, echocardiography, coronary angiography and other data of the two groups were collected for statistical analysis. The differences of clinical characteristics were compared between the two groups. Results The age, smoking history, stroke history, chronic kidney disease history and ventricular arrhythmia incidence in AMI with AF group were significantly higher than those in AMI without AF group (P<0.05). The hemoglobin, red blood cell count, triglyceride and estimated glomerular filtration rate in AMI with AF group were significantly lower than those in AMI without AF group, while the levels of serum uric acid, urea nitrogen, creatinine, cystatin C, brain natriuretic peptide and high-sensitivity C-reactive protein were significantly higher than those in AMI without AF group (P<0.05). Echocardiographic results show that compared with AMI without AF group, the left atrium diameter and right atrium diameter increased significantly (P<0.01), and the left ventricular ejection fraction decreased significantly (P<0.05), in AMI with AF group. There was no significant difference in the results of coronary angiography between the two groups (P>0.05). Conclusion The incidences of ventricular arrhythmia and heart failure are high in AMI with AF patients, and are prone to suffer from anemia and chronic kidney disease.

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邱静,苏冠华,孙雨霏,周庆,李豫,黄欣,帅欣欣,王祥.急性心肌梗死合并心房颤动患者的临床特点分析[J].中国动脉硬化杂志,2020,28(9):762~766.

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  • 收稿日期:2019-08-10
  • 最后修改日期:2019-08-15
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  • 在线发布日期: 2020-10-28