【摘要】 目的探讨肥胖患者伴发持续性心房颤动(简称房颤)相关危险因素分析。方法收集65例肥胖患者和175例非肥胖患者。分析比较肥胖及非肥胖两组患者伴发疾病,比较肥胖合并持续性房颤左房容积及血清C反应蛋白(CRP)水平。计算相对超额危险度比(RERI),归因比(AP)和交互作用指数(S)以评价肥胖与睡眠呼吸暂停综合征(OSAHS)在持续性房颤中是否存在交互作用。结果肥胖组一种、两种、三种疾病罹患率明显高于非肥胖组(32.30%vs 17.77%,χ~2=29.36,P=0.000,26.15%vs 17.14%,χ~2=12.89,P=0.041,26.15%vs11.42%,χ~2=19.34,P=0.037)。交互作用分析显示与OSAHS无肥胖个体相比,OSAHS同时合并肥胖个体罹患持续性房颤风险增加2.34倍(41.18%vs 12.33%,OR=3.34,95%CI:1.24～4.67,P=0.04)(RERI=1.75,95%CI:1.25～2.88;AP=0.56,95%CI:0.37～0.88;S=1.89,95%CI:1.24～3.87)。结论肥胖容易伴发持续性房颤,其发病可能与肥胖患者容易出现左房容积增加,血清CRP水平增高有关;肥胖与OSAHS在持续性房颤发病中起交互作用。更多还原

【Abstract】 Objective To investigate the related factors of persistent atrial fibrillation in obese patients. Methods Sixty-five obese patients and 175 non-obese patients were collected. Complication of two groups of patients with concomitant diseases, left atrial volume and serum C-reactive protein(CRP) levels was analyzed. The unconditional Logistic regression was performed to assess the association between obstructive sleep apnea syndrome, central obesityand persistent atrial fibrillation risk. Relative excess risk of interaction(RERI), the attributable proportion(AP) of interaction and the synergy index(S) and 95% confidence intervals(CI) of RERI, AP and S was used to explore interaction on persistent atrial fibrillation. Results The incidence of one type, two, three types disease in obesity group was higher than that in non-obesity group(32.30% vs 17.77%,χ~2=29.36,P=0.000,26.15% vs 17.14%,χ~2=12.89,P=0.041,26.15% vs 11.42%,χ~2=19.34,P=0.037). Compared with those who had not obstructive sleep apnea syndrome and were without central obesity, individuals with obstructive sleep apnea syndrome and central obesity increased risk of persistent atrial fibrillation(OR=3.34,95%CI: 1.24-4.67,P=0.04)(RERI=1.75, 95%CI: 1.25-2.88;AP=0.56,95%CI:0.37-0.88; S=1.89,95%CI: 1.24-3.87). Conclusion Obesity is significantly associated with persistent atrial fibrillation risk, which may be related to the increase of left atrial volume and serum CRP in obese patients. Obesity and sleep apnea syndrome play an interactive role in the pathogenesis of persistent atrial fibrillation.[Chinese Journal of Cardiac Pacing and Electrophysiology,2019,33(6):526-528]更多还原