摘要:Objective To investigate the relationship between serum bilirubin and atrial fibrillation(AF)in pa-tients with hypertension.Methods 460 patients with hypertension diagnosed as AF by electrocardiograph(ECG)were divided into AF group (n=226)and non-AF group(n=234).Serum bilirubin and other risk factors were detected and compared.Results The age of patients in AF group was older and left atrial diameter(LAD)was larger than that in non-AF group(P=0.000),with higher levels of serum level of total bilirubin(TBIL),direct bilirubin(DBIL), high sensitive C- reactive protein concentrations(hs-CRP),red blood cell distribution width(RDW),neutrophil/lymphocyte ratio(NLR),uric acid(UA),cystatinC(cysC),serum creatinine(CREA),D-dimmer and lower levels of triglycerides(TG),low-density lipoprotein(LDL),high-density lipoprotein(HDL),total cholesterol(TC),left ven-tricular ejection fraction(LVEF).The history of diabetes was related to AF.Multivariate logistic regression analysis showed that age(OR=1.115,Walds=41.120)and LAD(OR=1.220,Walds=28.710)were the significant inde-pendent risk factors of AF.TBIL(OR=1.078,Walds=4.321,P=0.038),DBIL(OR= 0.827,Walds=4.468,P=0.035)and TC(OR=0.207,Walds=11.471,P=0.001)were related with AF.Conclusions High level of serum bilirubin concentration,low level of TC,advanced age and high level of LAD will increase the risk of AF.%目的 探讨血清胆红素与高血压合并心房颤动(AF)及其危险因素的相关性.方法 将460例高血压患者依据心电图分为AF组(226例)和非AF组(234例).对血清胆红素和业已共识的传统危险因素进行检测,并比较之间的相关性.结果 AF组年龄及左心房内径(LAD)比非AF组大(P=0.000),血清总胆红素(TBIL)、直接胆红素(DBIL)、高敏C反应蛋白(hs-CRP)、红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞比值(NLR)、血尿酸(UA)、胱抑素(cysC)、血肌酐(CREA)及D-二聚体较非AF组高,血甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆固醇(TC)及左心室射血分数(LVEF)较非AF组低,糖尿病与AF发生相关;多因素logistic回归分析显示年龄(OR=1.115,Walds=41.120)和LAD(OR=1.220, Walds=28.710)是 AF发生的独立危险因素;TBIL(OR=1.078,Walds=4.321,P=0.038)和 DBIL(OR =0.827,Walds=4.468,P=0.035)及TC(OR=0.207,Walds =11.471,P=0.001)也与房颤发生密切相关.结论 血清胆红素含量高、胆固醇水平低、高龄及左房内径增大者发生AF的危险性越大.