冠心病患者新发心房颤动的危险因素与 核心机制研究
Risk Factors and Core Mechanisms of New-Onset Atrial Fibrillation in Patients with Coronary Heart Disease
摘要: 冠状动脉粥样硬化性心脏病(冠心病，CAD)与心房颤动(房颤，AF)是临床常共存且相互恶化预后的重要心血管疾病。在冠心病患者中，新发房颤(NOAF)显著增加卒中、心力衰竭及全因死亡风险。本文系统综述了冠心病患者发生NOAF的独立危险因素，并重点深入探讨了其三大核心病理生理机制：心肌缺血驱动的心房重构(以左心房内径增大为标志)、氧化应激(以血清尿酸为关键媒介)和系统性炎症(以C反应蛋白等为指标)。通过整合近年的关键循证医学证据，本文旨在为早期识别高危患者、制定个体化防治策略提供坚实的理论依据，并展望未来研究方向。
Abstract: Coronary heart disease (CHD) and atrial fibrillation (AF) are major cardiovascular conditions that frequently coexist and mutually exacerbate clinical outcomes. In patients with CHD, new‑onset atrial fibrillation (NOAF) significantly increases the risks of stroke, heart failure, and all‑cause mortality. This article systematically reviews the independent risk factors for NOAF in the CHD population, and provides an in‑depth exploration of three core pathophysiological mechanisms: myocardial ischemia‑driven atrial remodeling (marked by left atrial diameter enlargement), oxidative stress (with serum uric acid as a key mediator), and systemic inflammation (reflected by C‑reactive protein and other biomarkers). By integrating recent key evidence‑based findings, this review aims to establish a robust theoretical foundation for early identification of high‑risk patients and the development of individualized prevention and treatment strategies, and to propose directions for future research.
文章引用：聂蕾蕾, 谢东明. 冠心病患者新发心房颤动的危险因素与 核心机制研究[J]. 临床医学进展, 2026, 16(3): 1519-1526. https://doi.org/10.12677/acm.2026.163934

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