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目的:探讨代谢综合征(MS)与冠心病患者心房纤颤(AF)发生的关系。方法:入选住院拟行选择性冠状动脉造影(CAG),并确诊为冠心病(CHD)的患者1 805例,分为非MS组(n=1 150)及MS组(n=655),比较两组的相关临床资料,超声心动图及AF的情况。结果:MS组患者AF发生率明显高于非MS组(14.2%vs.8.1%,P<0.01),MS组左房内经(LAD),左室舒张末期内径(LVEDD)、左室壁厚度(LVPW),左室质量(LVM),左室质量指数(LVMI)均高于非MS组(P<0.05),左室射血分数(LVEF)明显低于非MS组(P<0.01)。Logistic回归分析显示冠心病患者发生AF的危险与年龄,左房增大、左室扩大及并发MS明显相关(OR分别为1.666、4.446、1.950、1.636,均P<0.05)。AF(n=188)与无AF患者(n=1 617)相关指标、单因素分析发现AF组MS发生率明显高于无AF组(49.3%vs.4.5%,P<0.01),体质量指数(BMI)、空腹血糖(FPG)水平明显升高(均P<0.05)。进一步Logistic回归分析显示MS组中肥胖与AF的发生关系最密切(OR:1.911,P<0.01)。结论:MS与冠心病患者发生AF的危险关系密切。
Objective: To investigate the relationship between metabolic syndrome (MS) and atrial fibrillation (AF) in patients with coronary heart disease. Methods: A total of 1 805 hospitalized patients with coronary artery disease (CHD) who underwent selective coronary angiography (CAG) were enrolled and divided into non-MS group (n = 1 150) and MS group (n = 655) The two groups of related clinical data, echocardiography and AF. Results: The incidence of AF in MS group was significantly higher than that in non-MS group (14.2% vs.8.1%, P <0.01). In MS group, the left atrium (LAD), left ventricular end diastolic diameter (LVPW), left ventricular mass (LVM) and left ventricular mass index (LVMI) were significantly higher than those in non-MS group (P <0.05). LVEF was significantly lower than that in non-MS group (P <0.01). Logistic regression analysis showed that the risk of AF in patients with coronary heart disease was significantly associated with age, left atrial enlargement, left ventricular enlargement and concurrent MS (OR = 1.666, 4.446, 1.950, 1.636, all P <0.05). The single factor analysis showed that the incidence of MS in AF group was significantly higher than that in non AF group (49.3% vs.4.5%, P <0.01), body mass index (n = 188) (BMI) and fasting blood glucose (FPG) were significantly increased (all P <0.05). Further Logistic regression analysis showed that obesity was most closely related to AF in MS group (OR: 1.911, P <0.01). Conclusion: MS is closely related to the risk of AF in patients with coronary heart disease.