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目的探讨影响急性心肌梗死(AMI)后新发心房颤动(简称房颤)的危险因素。方法收集2013年2月至2014年10月间心内科住院首次诊断为AMI患者共376例,根据心律情况分为窦性心律(简称窦律)组和房颤组。对其临床特征进行对比,并进行Logistic多因素回归分析。结果 376例AMI患者中,新发房颤46例,与窦律组比较,房颤组年龄更大,脑利钠肽前体、高敏C反应蛋白(hs-CRP)、肌钙蛋白峰值、TIMI评分、Killip分级更高,Logistic多因素回归分析显示:hs-CRP(OR值:3.429、95%CI:1.384~8.496、P=0.008)、肌钙蛋白峰值(OR值:1.014、95%CI:1.003~1.024、P=0.010)和TIMI评分(OR值:1.251、95%CI:1.020~1.534、P=0.031)与新发房颤相关。结论 hs-CRP、肌钙蛋白峰值、TIMI评分为影响AMI后新发房颤的独立危险因素。
Objective To investigate the risk factors of new-onset atrial fibrillation (AMF) after acute myocardial infarction (AMI). Methods A total of 376 patients with AMI who were initially diagnosed as inpatient for cardiology from February 2013 to October 2014 were collected and divided into sinus rhythm (AF) group and AF group according to the heart rhythm. The clinical features were compared and Logistic multivariate regression analysis. Results Among the 376 AMI patients, 46 cases were new-onset atrial fibrillation. Compared with the sinus rhythm group, the AF group was older and the brain natriuretic peptide precursor, high-sensitivity C-reactive protein (hs-CRP), troponin peak, TIMI Logistic regression analysis showed that hs-CRP (OR = 3.429, 95% CI: 1.384-8.496, P = 0.008), peak values of troponin (OR: 1.014, 95% CI: 1.003 ~ 1.024, P = 0.010) and TIMI score (OR: 1.251, 95% CI: 1.020-1.534, P = 0.031) were associated with atrial fibrillation. Conclusion The hs-CRP, troponin peak and TIMI score are independent risk factors of new-onset atrial fibrillation after AMI.