【作者】 张伟；

【导师】 木胡牙提；

【作者基本信息】 新疆医科大学 ， 内科学（专业学位）， 2020， 硕士

【摘要】 目的:探讨血清胱抑素C(cystatin c,Cys-C)水平与慢性心力衰竭合并房颤的相关性。方法:选取2014年1月1日至2018年12月31日在新疆医科大学第一附属医院心脏中心收治的心力衰竭患者348例,根据是否合并房颤分两组,慢性心衰不合并房颤组(A组)218例,合并房颤组(B组)130例,收集一般资料、血清学资料及心脏超声数据,建立数据库,行统计学分析。结果:(1)B组患者总胆红素、血清Cys-C、左室射血分数、左房内径均高于A组(P<0.05)。两组间年龄、血压、尿素、肌酐、空腹血糖、纤维蛋白原等均无显著性差异。(2)Spearman相关分析显示,血清Cys-C与房颤呈正相关(相关系数r=0.122,P=0.023),与总胆红素(r=0.158,P=0.003)、左房内径(r=0.131,P=0.015)、冠心病病史(r=0.157,P=0.003)等相关,但与左室射血分数、高血压病史、饮酒史等因素无关。(3)Logistic回归分析显示,校正总胆红素、左房内径、冠心病病史等因素后,Cys-C与房颤仍相关(OR=2.994,P=0.001),是房颤的危险因素。(4)相比其他病因的慢性心力衰竭,肺源性心脏病所致的心力衰竭更易引起的Cys-C的升高(P=0.043)。结论:血清Cys-C与心衰合并房颤相关,血清Cys-C水平偏高的慢性心衰患者应积极预防房颤发生。更多还原

【Abstract】 Objective:To investigate the relationship between serum cystine C(Cys-C)level and chronic heart failure complicated with atrial fibrillation.Methods:From January 1,2014 to December 31,2018,348 patients with heart failure in First affiliated Hospital of Xinjiang Medical University were divided into the following two groups: 218 patients with chronic heart failure without atrial fibrillation(group A)and 130 patients with chronic heart failure complicated with atrial fibrillation(group B).General data,Serological data and cardiac ultrasound data were collected,the establishment of a database,statistical analysis.Results:(1)The total bilirubin,serum Cys-C,left ventricular ejection fraction and left atrial diameter in group B were higher than those in group A(P<0.05).There were no significant differences in age,blood pressure,urea,creatine,fasting blood glucose and fibrinogen between the two groups.(2)Spearman correlation analysis showed that serum Cys-C was correlated with atrial fibrillation(r=0.122,P=0.023).It was correlated with totalbilirubin(r=0.158,P=0.003),left atrial diameter(r=0.131,P=0.015),history of coronary heart disease(r=0.157,P=0.003),but not with left ventricular ejection fraction(LVEF),hypertension history,drinking history and so on.(3)Logistic regression analysis showed that Cys-C was still correlated with atrial fibrillation after correction for total bilirubin,left atrial diameter,and history of coronary heart disease(OR=2.994,P=0.001).It is a risk factor for atrial fibrillation.(4)Compared with other causes of chronic heart failure,heart failure caused by pulmonary heart disease is more likely to cause an increase in Cys-C(P=0.043).Conclusion:The serum Cys-C is associated with atrial fibrillation in patients with heart failure.Patients with chronic heart failure with high serum Cys-C level should actively prevent atrial fibrillation.更多还原