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目的 观察阵发性房颤的随访情况和分析阵发性房颤进展的危险因素。方法 对216例阵发性房颤患者进行随访，观察其主要结局（是否发生房颤进展）和临床事件（卒中、心力衰竭、再住院和出血事件），再按是否房颤进展分为房颤进展组（n=87）和房颤未进展组（n=129）。采用巢式病例对照研究方法，进行单因素分析和多因素分析（采用多因素Logistic回归模型），分析影响房颤进展的危险因素。结果 216例阵发性房颤患者经过3.45年（中位数）随访发生房颤进展者87例，其发生进展率为40.2%，年进展率为11.7%。房颤进展组脑卒中、心力衰竭、房颤相关的再住院发生率均显著高于房颤未进展组（分别17% vs. 6%,18% vs. 5%,37% vs. 17%, 分别P<0.05，P<0.01和P<0.01）；两组间病死率及出血发生率差异未达到显著水平。多因素分析显示，年龄(OR 1.082,95%CI 1.016-1.392,P<0.05)、左房内径>45 mm(OR 2.339,95%CI 1.445-3.785,P<0.05)、CHADS2评分>3分(OR 1.382,95%CI 1.081-1.987,P<0.05)以及超敏C反应蛋白（hs-CRP）水平(OR 1.124,95%CI 1.005-2.345,P<0.05 )是房颤进展的独立危险因素。结论 阵发性房颤进展的年发生率为11.6%。影响房颤进展的独立危险因素为年龄、左房内径、hs-CRP水平及CHADS2评分。
Objective To observe the follow-up of paroxysmal atrial fibrillation and analyze the risk factors of paroxysmal atrial fibrillation. Methods A total of 216 patients with paroxysmal atrial fibrillation were followed up to observe the main outcome (whether or not atrial fibrillation progressed) and clinical events (stroke, heart failure, rehospitalization, and bleeding) and then to whether they were atrial fibrillation The progression group (n = 87) and non-progression AF group (n = 129). Using nested case-control study, univariate analysis and multivariate analysis (multivariate logistic regression model) were used to analyze the risk factors affecting the progression of atrial fibrillation. Results Among the 216 patients with paroxysmal atrial fibrillation, 87 cases progressed after a median follow-up of 3.45 years (40.2%), with an annual rate of 11.7%. The incidence of stroke, heart failure, atrial fibrillation-related rehospitalization in patients with atrial fibrillation was significantly higher than those in non-atrial fibrillation patients (17% vs. 6%, 18% vs. 5%, 37% vs. 17% P & lt; 0.05, P & lt; 0.01 and P & lt; 0.01, respectively); differences in mortality and bleeding between the two groups did not reach significant levels. Multivariate analysis showed that age (OR 1.082, 95% CI 1.016-1.392, P & lt; 0.05), left atrium diameter & gt; 45 mm (OR 2.339, 95% CI 1.445-3.785, P & lt; 0.05), CHADS2 score & gt; 3 (OR 1.382, 95% CI 1.081-1.987, P & lt; 0.05) and the level of hs-CRP (OR 1.124,95% CI 1.005-2.345, P & lt; 0.05) were independent risk of progression of atrial fibrillation factor. Conclusions The annual incidence of paroxysmal atrial fibrillation is 11.6%. Independent risk factors affecting the progression of atrial fibrillation were age, left atrium diameter, hs-CRP level and CHADS2 score.