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目的探讨心房颤动对肾小球滤过率(estimated Glomerular Filtration Rate,e GFR)有否影响。方法应用横断面研究方法,连续入选2013年10月1日至2015年5月1日心内科住院心房颤动患者,按心房颤动情况分为持续性心房颤动(包括永久性心房颤动)、阵发性心房颤动,选取无心房颤动者为对照组,应用酶法测定血清肌酐,应用CKD-EPI方程计算肾小球滤过率,统计分析心房颤动与肾小球滤过率二者相关性。结果 (1)正常对照组、阵发性心房颤动组和持续性心房颤动组在年龄、性别、体质量指数(Body Mass Index,BMI)、氨基末端钠尿肽(N-terminal pro-B-type natriuretic peptide,BNP)、血红蛋白(hemoglobin,HB)、吸烟、饮酒、高血压病、高脂血症、糖尿病,差异均无统计学意义(P>0.05);(2)正常对照组、阵发性心房颤动组和持续性心房颤动组三者肾小球滤过率呈逐步减低趋势,且差异有统计学意义(P<0.05);(3)经多因素线性回归分析得出:心房颤动与e GFR呈明显负相关,进一步校正年龄、性别、BNP、HB、吸烟、饮酒、高血压病、高脂血症、糖尿病因素后,其相关性仍然存在(P<0.05)。结论心房颤动可降低肾小球滤过率,是性别、年龄、高血压病、高脂血症、糖尿病之外的使肾小球滤过率降低的独立危险因素。
Objective To investigate whether atrial fibrillation affects glomerular filtration rate (eGFR). Methods A cross-sectional study was conducted and consecutively enrolled patients with atrial fibrillation in cardiology from October 1, 2013 to May 1, 2015. Patients were divided into continuous atrial fibrillation (including permanent atrial fibrillation) and paroxysmal Atrial fibrillation, no atrial fibrillation were selected as the control group, serum creatinine was measured by enzymatic method, the GFR was calculated by CKD-EPI equation, and the correlation between atrial fibrillation and glomerular filtration rate was statistically analyzed. Results (1) There were significant differences in age, sex, body mass index (BMI), N-terminal pro-B-type in normal control group, paroxysmal atrial fibrillation group and persistent atrial fibrillation group natriuretic peptide (BNP), hemoglobin (HB), smoking, drinking, hypertension, hyperlipidemia and diabetes mellitus. There was no significant difference between the two groups (P> 0.05) (P <0.05). (3) The multivariate linear regression analysis showed that atrial fibrillation and elective atrial fibrillation were associated with atrial fibrillation and persistent atrial fibrillation in patients with atrial fibrillation and persistent atrial fibrillation group, the glomerular filtration rate gradually decreased, and the difference was statistically significant GFR was negatively correlated. Correlation of age, gender, BNP, HB, smoking, drinking, hypertension, hyperlipidemia and diabetes was still significant (P <0.05). Conclusion Atrial fibrillation can reduce glomerular filtration rate, which is an independent risk factor for reducing glomerular filtration rate except for gender, age, hypertension, hyperlipidemia and diabetes.