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目的:分析冠状动脉旁路移植术(CABG)后心房颤动(AF)的危险因素,为CABG后AF的预防和治疗提供参考依据。方法:回顾性分析我院2006年8月至2009年10月收集的112例CABG患者的临床及相关资料,根据CABG后3d内是否出现AF持续5 min以上将患者分为AF组和非AF组,采用单因素和多因素分析方法探讨CABG后AF的危险因素。结果:112例患者,有24例符合CABG后AF标准,AF的发生率为21.4%。AF组和非AF组的年龄分别为(67.8±7.2)岁和(63.3±6.8)岁(P<0.05);AF组中男性比例91.7%高于非AF组男性比例68.2%(P<0.05)。单因素分析结果显示,年龄、性别、高血压史、左主干病变、二尖瓣反流、病变支数、射血分数和左心房前后径是CABG后AF的危险因素。采用logistic回归分析控制各因素的交互作用后,CABG后AF的危险因素主要有:年龄、高血压、左主干病变、二尖瓣反流、EF<49%和左心房大小其中影响最大的是左心房大小,左心房前后径>35mm的患者发生CABG后AF是<34mm的2.88倍。结论:CABG后AF的发生与年龄、高血压史、左主干病变、二尖瓣反流、EF及左心房大小等多个因素有关。对具有这些特征的患者,在CABG前应预防性地采用抗心律失常药进行治疗,以预防AF的发生。
Objective: To analyze the risk factors of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) and provide a reference for the prevention and treatment of AF after CABG. Methods: The clinical and related data of 112 CABG patients collected in our hospital from August 2006 to October 2009 were retrospectively analyzed. Patients were divided into AF group and non-AF group according to whether there was AF lasting more than 5 minutes after CABG. Univariate and multivariate analysis were used to explore the risk factors of AF after CABG. Results: Of the 112 patients, 24 met the CABG AF criteria, and the incidence of AF was 21.4%. The age of AF group and non-AF group were (67.8 ± 7.2) years and (63.3 ± 6.8) years old respectively (P <0.05). The male ratio in AF group was 91.7% higher than that in non-AF group (68.2%, P <0.05) . Univariate analysis showed that age, gender, history of hypertension, left main disease, mitral regurgitation, lesion count, ejection fraction and left atrium anterior and posterior diameter were the risk factors of AF after CABG. After logistic regression analysis was used to control the interaction of various factors, the risk factors of AF after CABG were as follows: age, hypertension, left main disease, mitral regurgitation, EF <49% and left atrial size Atrial size, left atrial anterior and posterior diameter> 35mm in patients with CABG AF is 2.88 times <34mm. Conclusion: The incidence of AF after CABG is related to many factors such as age, history of hypertension, left main trunk disease, mitral regurgitation, EF and left atrial size. Patients with these characteristics should be treated prophylactically with anti-arrhythmic agents before CABG to prevent AF.