冠状动脉搭桥术后新发房颤的危险因素分析及其对预后的影响

Analysis of Risk Factors for New Atrial Fibrillation after Coronary Artery Bypass Grafting and Its Influence on Prognosis

摘要: 目的：接受冠状动脉搭桥手术(CABG)的患者术后易并发心房颤动(AF)，心房颤动的发生显著增加死亡、卒中的风险，并且影响患者的远期预后。本研究通过分析接受冠状动脉搭桥手术的患者术后出现房颤的危险因素，并随访出现房颤患者远期预后，从而为拟行冠状动脉搭桥手术患者围手术期的风险评估提供一定的理论依据。方法：本研究分为两组，采用对照原则，手术后出现新发心房颤动(POAF)的患者被指定为病例组，而没有出现POAF的患者被指定为对照组。采用卡方检验和独立样本t检验分析这些变量。使用逻辑回归模型进行多元分析，筛选出与AF相关的危险因素。结果：高龄、心功能水平、术前合并瓣膜病史、同期接受瓣膜手术、术中主动脉阻断时间及体外循环运转时间均具有统计学意义。通过多因素回归分析得到搭桥术后独立危险因素包括高龄、心功能水平、主动脉阻断时间、体外循环运转时间。

Abstract: Objective: Patients undergoing coronary artery bypass grafting (CABG) are prone to postoperative atrial fibrillation (AF), which significantly increases the risk of death and stroke, and affects the long-term prognosis of patients. This study analyzed the risk factors of postoperative atrial fibrilla-tion in patients undergoing coronary artery bypass grafting and followed up the long-term progno-sis of patients with atrial fibrillation, thus providing a theoretical basis for perioperative risk as-sessment in patients undergoing coronary artery bypass grafting. Methods: The study was divided into two groups, using the control principle. Patients with new onset atrial fibrillation after surgery were assigned as the case group, while patients without POAF were assigned as the control group. Chi-square test and independent sample t test were used to analyze these variables. Multivariate analysis was performed using logistic regression model to screen out the risk factors associated with AF. Results: Age, level of cardiac function, preoperative history of valvular disease, concurrent valve operation, time of aortic occlusion and operation time of cardiopulmonary bypass were statis-tically significant. Independent risk factors after bypass surgery found by multivariate regression analysis include old age, cardiac function level, aortic occlusion time, and cardiopulmonary bypass operation time.