| 朱小慧,王长远,吉训明,王 晶,曹 涛,邢绣荣.急诊阵发性心房颤动患者血清肌钙蛋白水平升高的相关影响因素分析[J].,2019,19(11):2104-2107 |
| 急诊阵发性心房颤动患者血清肌钙蛋白水平升高的相关影响因素分析 |
| Analysis of the Related Factors for the Troponin I Elevation in Patients with Paroxysmal Atrial Fibrillation |
| 投稿时间：2018-12-31 修订日期：2019-01-29 |
| DOI：10.13241/j.cnki.pmb.2019.11.021 |
| 中文关键词: 心房颤动 肌钙蛋白I 影响因素 |
| 英文关键词: Atrial fibrillation Troponin I Factors |
| 基金项目:北京市扬帆计划重点医学专业基金项目(ZYLX01706) |
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| 中文摘要: |
| 摘要 目的：通过比较急诊就诊时不同肌钙蛋白I(TnI)水平阵发性心房颤动(48小时内)患者临床特征的差异，探讨血清肌钙蛋白水平升高的相关影响因素，为临床识别高危房颤患者提供参考依据。方法：选取2016-2017年于宣武医院急诊诊断为阵发性房颤的患者110例，记录既往病史、临床症状体征、实验室检验结果及测定血清TnI水平，并根据TnI水平将患者分为TnI正常组(<0.023 μg/L)和TnI升高组(>0.023 μg/L)，结合患者既往病史及用药史给予普罗帕酮或可达龙药物转复治疗。结果：急诊阵发房颤患者TnI升高发生率为11.8%，TnI峰值的平均值0.210 μg/L，中位数0.067 μg/L。TnI正常组和TnI升高组性别构成、血压、心室率、胸闷、头晕、乏力、高血压、糖尿病、慢性阻塞性肺部疾病、射频消融术、转复成功率及NT-proBNP比较差异均无统计学意义(P>0.05)；年龄、心悸、胸痛、腹背部不适感、冠心病、房颤病史、心电图ST段压低比较差异均有统计学意义(P>0.05)。二元logistic回归分析显示既往冠心病史及入室心电图ST段压低为血清TnI升高的影响因素。结论：既往冠心病史及心电图ST段压低为阵发房颤患者肌钙蛋白升高的影响因素，临床上需关注高龄以心绞痛样症状就诊的首次房颤患者。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate related factors for the troponin i elevation in patients with paroxysmal atrial fibrillation through comparing the clinical features of paroxysmal atrial fibrillation (within 48 hours) patients with different levels of troponin I (TnI) in the serum. Methods: A total of 110 patients with paroxysmal atrial fibrillation in the emergency department of Xuanwu Hospital from 2016 to 2017 were enrolled. The patient's past medical history, clinical signs and symptoms, laboratory examination and serum TnI levels were recorded. According to the serum TnI levels, the patients were divided into two groups: TnI normal group (<0.023 μg/L) and TnI el- evated group (>0.023 μg/L). All the patients were treated by propafenone or amiodarone for drug cardioversion according to the medical history and medication history. Results: The incidence of TnI elevation was 11.8%. the mean TnI peak was 0.210 μg/L, with a median of 0.067 μg/L. There was no significant difference in the gender, systolic pressure(SYS), ventricular rate, chest tightness, dizziness, fatigue, hypertension, diabetes, chronic obstructive pulmonary disease(COPD), radiofrequency ablation(RA), effective rate of cardioversion and NT-proBNP between TnI normal group and TnI elevated group(P>0.05). There were significant differences in age, palpitations, chest pain, back & abdominal discomfort, coronary artery disease(CAD), atrial fibrillation(AF) history, and ST segment depression on the ini- tial electrocardiogram (P<0.05). According to the binary logistic regression analysis, the history of coronary heart disease and ST-seg- ment depression were the influencing factors for the elevation of serum TnI level. Conclusion: The history of coronary heart disease and ST segment depression on the initial ECG are the influencing factors for the elevation of serum TnI level. We should pay close attention to those elderly patients with first diagnosed AF and angina symptomatic AF in clinical works. |
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