老年心房颤动患者左心房收缩功能及其影响因素分析

摘要

Objective To evaluate the variation of left atrial systolic function and its determinants in patients with paroxysmal atrial fibrillation. Methods By using color Doppler ultrasonography, LAEF ( left atrial ejection force ) and LAEFI were measured in 50 patients without paroxysmal atrial fibrillation ( control group ) and 52 patients with paroxysmal atrial fibrillation ( trial group ). Related clinical variables and echo parameters were compared between these two groups, and stepwise regression was made to determine the influencing factors of LAEFI variation in paroxysmal atrial fibrillation group. Results The figures of LAEF and LAEFI in patients with paroxysmal atrial fibrillation were larger than those of control group ( P ＜ 0.01 ). Logistic regression demonstrated that the change of LAEFI could be used as correlated factor of paroxysmal atrial fibrillation ( P ＜ 0.01, OR:2.36 ). Multivariate stepwise regression demonstrated that SBP, AGE and LVMI entered the regression equation Y =-0.223 + 0. 002325 AGE + 0. 0008012 SBP + 0. 0004265 LVMI. Conclusion The change in left atrial systolic function can be used as correlated factor of paroxysmal atrial fibrillation. SBP, AGE and LVMI are the most important determinants of left atrial systolic function in patients with paroxysmal atrial fibrillation.%目的 评价老年阵发性心房颤动患者左心房收缩功能的改变,并进一步探讨导致其改变的主要影响因素.方法 应用彩色多普勒超声诊断技术,测量52例老年阵发性心房颤动患者及50例正常对照组的左心房射血力(LAEF)、左心房射血力指数(LAEFI),并进行比较;应用多因素逐步回归方法探讨阵发性心房颤动患者LAEFI改变的主要影响因素.结果 阵发性心房颤动组LAEF、LAEFI均较正常对照组增大 (P<0.01);Logistic回归分析显示LAEFI改变是阵发性心房颤动的独立危险因素(P<0.01,OR:2.36);多因素逐步回归分析显示阵发性心房颤动患者LAEFI改变与收缩压(SBP)、年龄(AGE)、左室质量指数(LVMI)具有显著回归效果,回归方程为Y=-0.223+0.002325 AGE +0.0008012 SBP +0.0004265 LVMI.结论 LAEFI改变是心房颤动发作的独立危险因素;年龄、SBP、LVMI是影响阵发性心房颤动患者左心房收缩功能的重要因素.