摘要
目的探讨冠心病(CHD)患者血清中肝酶水平与心房颤动(AF)发生的关系。方法收集江苏省常州市武进人民医院心血管内科2018年1月至2020年1月确诊为CHD的患者1520例,比较入院时AF与非AF患者基线资料、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ谷氨酰转肽酶(GGT)、个人史和既往史等,并行多因素logistic回归分析,探究CHD患者中AF发生的独立危险因素,绘制受试者操作特征(ROC)曲线。结果入院时患有AF者共152例,AF发生率为10%。比较AF与非AF患者临床资料发现,两者在GGT、年龄、高血压史和急性冠脉综合征(ACS)史中,差异有高度统计学意义(P<0.01);在AST和ALT中,差异有统计学意义(P<0.05)。进一步多因素loistic回归分析示,GGT[OR=1.018,95%CI(1.013~1.024)]、年龄[OR=1.030,95%CI(1.012~1.048)]、高血压史[OR=2.667,95%CI(1.671~4.257)]和ACS史[OR=2.960,95%CI(1.896~4.622)]是发生AF的独立危险因素(P<0.05)。绘制ROC曲线发现,GGT在预测AF发生中曲线下面积为0.693。结论在CHD患者中,肝酶水平与AF的发生相关,特别是GGT的升高与AF的存在独立相关,GGT可能是AF风险的循环标志物。
Objective To investigate the relationship between serum liver enzyme level and atrial fibrillation(AF)in patients with coronary heart disease(CHD).Methods A total of 1520 patients diagnosed with CHD from January 2018 to January 2020 were collected from the Department of Cardiovascular Medicine,Changzhou Wujin People’s Hospital,Jiangsu Province.The baseline data,aspartate aminotransferase(AST),alanine aminotransferase(ALT),γglutamyl transpeptidase(GGT),personal history,and past history of AF and non-AF patients at admission were compared.Multi-factor logistic regression analysis was carried out to explore the independent risk factors for AF in CHD patients,and the receiver operating characteristic(ROC)curve was drawn.Results There were 152 patients with AF on admission,and the incidence of AF was 10%.The comparison of the clinical data of AF and non-AF patients showed that,in GGT,age,history of hypertension,and history of acute coronary syndrome(ACS),the differences were highly significant(P<0.01);there were statistical significances in AST and ALT(P<0.05).Multiple logistic regression analysis showed that,GGT[OR=1.018,95%CI(1.013-1.024)],age[OR=1.030,95%CI(1.012-1.048)],history of hypertension[OR=2.667,95%CI(1.671-4.257)],and ACS history[OR=2.960,95%CI(1.896-4.622)]were independent risk factors for AF(P<0.01).ROC curve was drawn and it was found that the area under the curve of GGT was 0.693 in predicting the occurrence of AF.Conclusion In CHD patients,liver enzyme level is associated with the occurrence of AF,especially the elevation of GGT is independently associated with the presence of AF,and GGT may be a circulating marker of AF risk.
作者
赵霞
李勇
ZHAO Xia;LI Yong(School of Medicine,Jiangsu University,Jiangsu Province,Zhenjiang 212013,China;Department of Cardiovascular Medicine,Changzhou Wujin People’s Hospital,Jiangsu Province,Changzhou 213017,China)
出处
《中国医药导报》
CAS
2022年第14期56-59,共4页
China Medical Herald
基金
江苏省基础研究计划自然科学基金青年基金项目(BK20140249)
江苏省青年医学重点人才项目(QNRC2016311)
江苏省常州市高层次卫生人才培养项目(2016CZBJ 052)
江苏省常州市科技局应用基础研究计划项目(CJ20179004)。
关键词
冠心病
心房颤动
肝酶
危险因素
Coronary heart disease
Atrial fibrillation
Liver enzyme
Risk factor
