【摘要】 目的:本研究旨在分析无症状性心房颤动(房颤)患者的临床特征和预后情况。方法:回顾性分析2015年9月至2019年7月在金塔县人民医院住院期间确诊有心房颤动的患者426例,根据欧洲心律学会(EHRA)房颤症状评分将其分为无症状性房颤组(n=122)和症状性房颤组(n=304)。比较两组患者的临床特征,通过多因素Logistic回归分析明确无症状性房颤的独立相关因素。随访终点为全因死亡、心血管死亡和脑血管事件,通过Kaplan-Meier法比较两组的临床预后。结果:无症状性房颤患者比例为28.6%(122/426)。多因素Logistic分析显示,年龄(OR=1.183,95%CI:1.132～1.236,P <0.001)、男性(OR=3.803,95%CI:2.049～7.059)和入院心率(OR=1.057,95%CI:1.031～1.083)均与无症状性房颤具有独立相关性(P均<0.001)。平均随访(371±26)d显示,无症状性房颤患者的心血管死亡发生率显著高于症状性房颤患者(7.9%vs. 2.9%,P=0.030)。两组患者的全因死亡发生率(9.6%vs. 8.8%,P=0.789)和脑血管事件发生率(3.5%vs. 1.8%,P=0.530)的差异无统计学意义。结论:无症状性房颤发生率高。高龄、男性和入院心率偏慢是无症状房颤的独立危险因素。相较于症状性房颤患者,无症状性房颤患者具有更高的心血管死亡发生率。更多还原

【Abstract】 Objectives: This study aims to analyze the clinical characteristics and prognosis of the patients with asymptomatic atrial fibrillation(AF).Methods: We retrospectively reviewed medical records of 426 patients, who hospitalized in JinTa People’s hospital from September 2015 to July 2019, with AF. Patients were divided into the asymptomatic AF group(n=122) and the symptomatic AF group(n=304) by European Heart Rhythm Association(EHRA) score, clinical features were compared between the two groups. Multivariate logistic regression analysis was performed to identify independent predictors for asymptomatic AF. The endpoints were defined as all-cause death, cardiovascular death and cerebrovascular events. Kaplan–Meier analyses with a log-rank test was used to assess prognosis between the two groups. Results: Percent of asymptomatic AF was 28.6%(122/426) in this patient cohort. Multivariate analysis showed that elderly age(OR=1.183, 95%CI:1.132-1.236), male gender(OR=3.803, 95%CI:2.049-7.059) and admission heart rate(OR=1.057, 95%CI:1.031-1.083) were significantly associated with asymptomatic AF(all P<0.001). During an average of(371±26) days follow-up, significantly higher rate of cardiovascular death was found in patients with asymptomatic AF compared to patients with symptomatic AF(7.9% vs. 2.9%, P=0.030). All-cause death(9.6% vs. 8.8%, P=0.789) and cerebrovascular events rate(3.5% vs. 1.8%, P=0.530) were similar between the two groups. Conclusions: Asymptomatic AF is common in clinical practice and is associated with elderly age, male gender and lower heart rate at admission. Asymptomatic AF is associated with higher cardiovascular mortality as compared to patients with symptomatic AF during follow-up in this patient cohort.更多还原