影响非体外循环冠状动脉旁路移植术后心房纤颤术前因素的多因素分析

摘要

目的 探讨术前因素对非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)后心房颤动(postoperative atrial fibrillation,POAF)发生率的影响.方法 回顾性分析我科2010年1月～2011年12月237例首次接受OPCAB的临床资料,对POAF的术前影响因素进行单因素和logistic回归分析.结果 POAF发生率16.9％(40/237).logistic回归分析显示年龄(OR=1.068,95％CI:1.019 ～1.118,P=0.006)、BMI(OR=1.138,95％ CI:1.010 ～1.281,P=0.034)、舒张压(OR=1.056,95％ CI:1.020 ～1.094,P=0.002)及左心房前后径(OR=1.089,95％ CI:1.002～1.184,P=0.046)是OPCAB后POAF的术前危险因素.结论 年龄、BMI、舒张压及左心房前后径是OPCAB后发生POAF的术前危险因素.%Objective The aim of the study is to analyze the preoperative risk factors of the atrial fibrillation after off-pump coronary artery bypass grafting (OPCAB).Methods We retrospectively analyzed the clinical data of 237 patients undergoing OPCAB for the first time from January 2010 to December 2011 by using single factor analysis and multivariate logistic regression analysis.Results The overall incidence of postoperative atrial fibrillation (POAF) was 16.9％ (40/237).Logistic regression analysis showed that age (OR =1.068,95％ CI:1.019-1.118,P =0.006),BMI(OR =1.138,95％ CI:1.010-1.281,P =0.034),diastolic blood pressure(OR =1.056,95％ CI:1.020-1.094,P =0.002),and left atrial anteroposterior diameter (OR =1.089,95％ CI:1.002-1.184,P =0.046) were the preoperative risk factors of POAF after OPCAB.Conclusion Age,BMI,diastolic blood pressure and anteroposterior diameter of the left atrium are the preoperative risk factors of POAF after OPCAB.