摘要
目的 探讨心房频率联合左心房内径(LAd)对应用伊布利特转复心房颤动患者成功率的预测价值。方法 选取2012-09-01-2021-06-30泰安市中心医院住院的130例阵发性或持续性非瓣膜性心房颤动患者作为研究对象,均应用伊布利特进行转复治疗。根据能否转为窦性心律,将患者分为转复成功组90例和转复不成功组40例,统计2组患者一般资料、心房率、心室率、LAd、左心室舒张末期内径(LVEDd)和左室射血分数(LVEF)等,logistic回归分析筛选影响伊布利特转复房颤的危险因素,分别对心房率、LAd及两者联合进行绘制受试者工作特征(ROC)曲线,评价两者联合对伊布利特转复心房颤动成功率的预测价值。结果 转复成功组与不成功组比较,性别(χ^(2)=7.105,P=0.008)、阵发性心房颤动比例(χ^(2)=40.846,P<0.001)、胆固醇浓度(t=2.337,P=0.021)和血浆氨基末端脑钠肽前体(NT-proBNP)水平(P=0.015)差异有统计学意义。转复成功组心房率为(376.522±62.685)次/min,低于不成功组的(433.275±104.327)次/min,t=3.840,P<0.001;LAd为(41.144±7.460) mm,低于转不成功组的(46.325±7.234) mm,t=3.688,P<0.001。多因素logistic回归分析结果显示,阵发性心房颤动(OR=15.054,95%CI为5.033~45.026,P<0.001)、女性(OR=3.299,95%CI为1.028~10.583,P=0.045)、心房率(OR=0.992,95%CI为0.985~0.998,P=0.014)和LAd(OR=0.925,95%CI为0.861~0.993,P=0.032)是影响伊布利特转复心房颤动成功率的独立影响因素。心房率预测伊布利特转复心房颤动成功率ROC曲线下面积为0.655,灵敏度为76.7%,特异度为42.5%;LAd预测伊布利特转复心房颤动成功率ROC曲线下面积为0.708,灵敏度为84.4%,特异度为67.5%,两者联合ROC曲线下面积为0.758,95%CI为0.671~0.844,P<0.001。结论 心房率联合LAd对伊布利特转复心房颤动成功率具有预测价值。
Objective To explore the predictive value of atrial frequency and left atrial diameter(LAd)on the success rate of atrial fibrillation patients converted by ibutilide.Methods From September 1,2012to June 30,2021,130patients with paroxysmal or persistent nonvalvular atrial fibrillation hospitalized in Tai'an Central Hospital were selected as the study subjects,and they were all treated with ibutilide for conversion.According to whether it could be converted to sinus rhythm,the patients were divided into 90patients in the successful conversion group and 40patients in the unsuccessful conversion group.The general information,atrial rate,ventricular rate,LAd,left ventricular end diastolic dimension(LVEDd)and left ventricular ejection fraction(LVEF)of the patients in the two groups were statistically analyzed.Logistic regression analysis was used to screen for risk factors affecting the conversion of ibutilide to atrial fibrillation.We drew the receiver operating characteristic(ROC)curve for atrial rate,LAd and the combination of the two and evaluated the predictive value of the combination of the two on the success rate of ibutilide converting to atrial fibrillation.Results Compared the successful and unsuccessful conversion groups,genders(χ^(2)=7.105,P=0.008),the proportion of paroxysmal atrial fibrillation(χ^(2)=40.846,P<0.001),cholesterol concentration(t=2.337,P=0.021),and N termi-nal pro brain natriuretic peptide(NT-proBNP)levels showed statistically significant differences.The atrial rate in the successfully converted group was(376.522±62.685)beats/min,lower than that in the unsuccessful group(433.275±104.327)beats/min,t=3.840,P<0.001.LAd was(41.144±7.460)mm,lower than(46.325±7.234)mm in the un-successful conversion group,t=3.688,P<0.001.Multivariate logistic regression analysis showed that paroxysmal atrial fibrillation(OR=15.054,95%CI was 5.033-45.026,P<0.001),female(OR=3.299,95%CI was 1.028-10.583,P=0.045),atrial rate(OR=0.992,95%CI was 0.985-0.998,P=0.014),LAd(OR=0.925,95%CI was 0.861-0.993,P=0.032)NT-proBNP(OR=1.000,95%CI was 0.999-1.000,P=0.071)were independent factors affecting the success rate of ibutilide in converting atrial fibrillation.The area under the ROC was 0.655,the sensitivity was 76.7%,and the specificity was 42.5%;LAd predicted that the area under ROC of the success rate of ibutilide in conver-ting atrial fibrillation was 0.708,the sensitivity was 84.4%,and the specificity was 67.5%.The area under the ROC of the combination of the two was 0.758,(95%CI was 0.671-0.844,P<0.001).Conclusion Atrial rate combined with LAd has predictive value for the success rate of ibutilide conversion atrial fibrillation.
作者
李中兰
李妍
张艳芹
李文佳
宋兆峰
LI Zhonglan;LI Yan;ZHANG Yanqin;LI Wenjia;SONG Zhaofeng(Department of Cardiopulmonary Vascular Diseases,Affilicted Tai'an Central Hospital to Qingdao University,Tai'an,Shandong 271000,China;Department of Pediatrics,Tai'an Mount Taishan District People's Hospital,Tai'an,Shandong 271000,China;Department of Nursing,Mount Tai Nursing Vocational College,Tai'an,Shandong 271000,China)
出处
《社区医学杂志》
CAS
2023年第19期1016-1021,共6页
Journal Of Community Medicine
基金
泰安市科技引导计划(2021NS417)。
关键词
伊布利特
心房颤动
成功率
心房频率
左心房内径
ibulett
atrial fibrillation
success rate
atrial rate
left atrial dimension
