心房颤动对心力衰竭患者预后的影响.pdfVIP

心脏杂志 (Chin Heart J)2008，20(1) ·87· · 临床研究 · 心房颤动对心力衰竭患者预后的影响 陈志术 ，陈志跃 ，辛苏萍 ，沈亚萍 (1．江苏大学附属武进医院心内科，江苏常州213000；2．宁波第二医院，浙江宁波315010) 摘要：目的 探讨心房颤动(AF)对心力衰竭(HF)患者远期预后的影响。方法 回顾性研究63例HF患者，根据 HF是否并发AF的临床特点：分有AF组(A组)，无AF组(B组)，并随访(23±8)月，观察AF对HF远期不良事件 发生及预后的影响。结果 ①左心房内径，A组大于B组 [(49±8)mm (43±7)mm，P0．05]；左心室射血分 数，A组低于B组[(33±5)％ (42±6)％，P0．05]；②脑栓塞发生率，A组高于B组(26％ 6％，P0．05)； ③快速性心律失常，A组高于B组(77％ 47％，P0．05)；④不良事件发生：A组因HF加重或脑栓塞发生的再 住院率高于B组(P0．01)；⑤病死率：A组多于B组 (32％ 13％，P0．O1)。结论 HF基础上发生AF，预示 着对原发性心脏疾病的远期不良事件发生增多，预后影响较大。 关键词：心房颤动；心力衰竭；远期不良事件；预后因素 中图分类号：R541．75 文献标识码：A 文章编号：1009-7236(2008)O1-087-03 Effect of atrial fibrillation on long-term prognostic factors in patients with heart failure CHEN Zhi—shu ，CHEN Zhi—yue ，XIN Su-ping ，SHEN Ya-ping (1．Wujin Hospital，Jangsu University，Changzhou 2 1 3002，Jiangsu，China；2．Second Hospital of Ning— bo City，Ningbo 315010，Zhejiang，China) Abstract：AIM To explore the effect of atrial fibrillation(AF)on long—term prognostic factors in pa— tients with heart failure(HF)．METHODS Sixty—three patients were divided into AF group(group A) and non—AF group(group B)and their clinical outcomes were followed up for 23±8 months．RESULTS ①The left cardiac atrium inner diameter in group A was larger than that in group B[(49 4-8)mm (43±7)mm，P0．05]and the left ventricular ejection fraction in group A was lower than that in group B[(33±5)％ (42±6)％，P0．05]②The incidence of cerebral embolism in group A was higher than that in group B(26％ 6％，P0．05)③The ventricular rate and ventricular tachyarrhythmia in group A were higher than those in group B(77％ 47％，P0．05)④Group A，due to HF aggrava— tion or cerebral embolism．had higher rehospitalization rate than group B(46 29，P0．01)⑤The death rate i