CAJ | 학술논문

目的：研究左室限制性充盈障碍与急性心肌梗死（AMI）新发心房颤动（房颤）的关系。方法回顾性分析AMI患者288例，患者住院后1～3 d均行超声心动图检查。根据是否有新发房颤分为房颤组和非房颤组。对两组患者的性别、年龄、梗死部位、心功能分级、危险因素、冠状动脉病变支数、药物应用等临床特征及左室射血分数、左房内径、E/A比值等超声心动图参数进行比较，并对临床及超声心动图参数与新发房颤的关系进行了单因素及多因素logistic回归分析。结果入选患者中新发房颤发生率14.2%（42/288）。两组患者临床及超声指标比较，房颤组女性比例、平均年龄、Killip分级≥Ⅱ级比例、左心房内径、左室限制性充盈障碍的比例、利尿剂使用率、冠状动脉三支病变的比例均高于非房颤组患者（P＜0.05～0.01）。多因素Logistic回归分析发现年龄＞65岁、左心房内径＞40 mm、Killip分级≥Ⅱ级、左室舒张功能限制性充盈障碍是AMI患者出现新发房颤的独立危险因素，OR值及95%CI分别为2.28（1.78～4.97），1.71（1.13～2.86）,1.49（1.03～1.74）和2.58（1.64～3.75）。结论左室限制性充盈障碍是急性心肌梗死新发房颤的独立危险因素。
목적：연구좌실한제성충영장애여급성심기경사（AMI）신발심방전동（방전）적관계。방법회고성분석AMI환자288례，환자주원후1～3 d균행초성심동도검사。근거시부유신발방전분위방전조화비방전조。대량조환자적성별、년령、경사부위、심공능분급、위험인소、관상동맥병변지수、약물응용등림상특정급좌실사혈분수、좌방내경、E/A비치등초성심동도삼수진행비교，병대림상급초성심동도삼수여신발방전적관계진행료단인소급다인소logistic회귀분석。결과입선환자중신발방전발생솔14.2%（42/288）。량조환자림상급초성지표비교，방전조녀성비례、평균년령、Killip분급≥Ⅱ급비례、좌심방내경、좌실한제성충영장애적비례、이뇨제사용솔、관상동맥삼지병변적비례균고우비방전조환자（P＜0.05～0.01）。다인소Logistic회귀분석발현년령＞65세、좌심방내경＞40 mm、Killip분급≥Ⅱ급、좌실서장공능한제성충영장애시AMI환자출현신발방전적독립위험인소，OR치급95%CI분별위2.28（1.78～4.97），1.71（1.13～2.86）,1.49（1.03～1.74）화2.58（1.64～3.75）。결론좌실한제성충영장애시급성심기경사신발방전적독립위험인소。
Objective To study the relationship between left ventricular restrictive filling dysfunction and risk of new-onset atrial fibrillation (AF) after acute myocardial infarction (AMI).Methods The data of 288 AMI patients were retrospectively analyzed, and all patients were given echocardiogram examination within 1 d to 3 d after hospitalization and then divided into AF group and non-AF group. The data of sex, age, infarction position, NYHA grading, risk factor, number of diseased coronary vessels, drug administration, LVEF, LVEDd and ratio of E/A were compared between 2 groups. The relationship between clinical or echocardiogram parameters and new-onset AF were given single factor and multi-factor Logistic regression analysis.Results The incidence of new-onset AF was 14.2% (42/288) in all included patients. The percentages of female patients and patients with Killip≥Ⅱ, left ventricular restrictive filling dysfunction and 3-vessel lesion, average age, LVEDd, diuretics usage rate were all higher in AF group than those in non-AF group (P<0.05 toP<0.01). Logistic regression analysis found that age>65 (OR=2.28, 95%CI: 1.78~4.97), LVEDd>40 mm (OR=1.71, 95%CI: 1.13~2.86), Killip≥Ⅱ (OR=1.49, 95%CI:1.03~1.74) and left ventricular restrictive filling dysfunction (OR=2.58, 95%CI: 1.64~3.75) were independent risk factors of new-onset AF.Conclusion Left ventricular restrictive filling dysfunction is a independent risk factor of new-onset AF of AMI.