作者：雷吉勇，罗达，黎明江

单位：

430060湖北省武汉市，武汉大学人民医院心内科

Units：

Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China

关键词：

心律失常，心性；非瓣膜性心房颤动；冠状动脉钙化；临床特征；影响因素分析

Keywords：

Arrhythmias, cardiac; Non-valvular atrial fibrillation; Coronary artery calcification; Clinical features;Root cause analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.184

Funds：

湖北省卫健委面上项目（WJ2021M145）

摘要：

目的　探讨非瓣膜性心房颤动（NVAF）患者合并冠状动脉钙化（CAC）的临床特征及影响因素。方法　回顾性选取2020—2021年于武汉大学人民医院心内科接受治疗的181例NVAF患者。根据冠状动脉CTA检查结果，将发生CAC的患者纳入钙化组，未发生CAC的患者纳入无钙化组。比较两组一般资料、生化指标及超声心动图指标。采用多因素Logistic回归分析探讨NVAF患者合并CAC的影响因素。结果　181例患者中，发生CAC 97例（53.6%）。钙化组年龄、使用他汀类药物者占比、CHA2DS2-VASc评分、TC、TG、LDL-C、LDL-C/HDL-C、非高密度脂蛋白胆固醇（non-HDL-C）、空腹血糖（FBG）高于无钙化组（P ＜0.05）。多因素Logistic回归分析结果显示，年龄增长〔OR =1.058，95%CI （1.005，1.114）〕、男性〔OR =3.400，95%CI （1.355，8.534）〕、冠心病〔OR =4.177，95%CI （1.152，15.152）〕是NVAF患者合并CAC的危险因素（P ＜0.05）。结论　NVAF合并CAC患者年龄较大，他汀类药物使用率较高，表现为更高的CHA2DS2-VASc评分、TC、TG、LDL-C、LDL-C/HDL-C、non-HDL-C及FBG。年龄增长、男性、冠心病为NVAF患者合并CAC的独立危险因素。

Abstract：

Objective　To investigate the clinical characteristics and influencing factors of coronary artery calcification(CAC) in patients with non-valvular atrial fibrillation (NVAF) . Methods　A total of 181 patients with NVAF who were treatedin the Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University from 2020 to 2021 were retrospectivelyselected. According to the results of coronary CTA examination, patients with CAC were included in the calcification group, andpatients without CAC were included in the non-calcification group. The general data, biochemical and echocardiographic indexesof the two groups were compared. Multivariate Logistic regression was used to analyze the influencing factors of CAC in patientswith NVAF. Results　Among the 181 patients, 97 (53.6%) had CAC. The age, proportion of statin users, CHA2DS2-VASc score,TC, TG, LDL-C, LDL-C/HDL-C, non-high-density lipoprotein cholesterol (non-HDL-C) , and fasting blood glucose (FBG) inthe calcification group were higher than those in the non-calcification group (P < 0.05) . Multivariate Logistic regression analysisshowed that age increase [OR =1.058, 95%CI (1.005, 1.114) ] , male [OR =3.400, 95%CI (1.355, 8.534) ] , and coronary heart disease[OR =4.177, 95%CI (1.152, 15.152) ] were the risk factors for CAC in patients with NVAF (P < 0.05) . Conclusion　 Patients withNVAF combined with CAC are older and have a higher statin use rate, and higher CHA2DS2-VASc score, TC, TG, LDL-C, LDL-C/HDL-C, non-HDL-C and FBG. Age increase, male, and coronary heart disease are the risk factors for CAC in patients with NVAF.

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