摘要
目的 探讨术前HbA_(1)c控制对心房颤动(AF)患者导管消融术预后的影响。方法 选取2015年6月至2021年6月于南京医科大学附属常州第二人民医院心血管内科行首次三维立体标测指导下导管射频消融治疗的AF患者402例,按照HbA_(1)c水平分为HbA_(1)c<6%组(n=200)、6%≤HbA_(1)c<6.5%组(n=122)及HbA_(1)c≥6.5%组(n=80)。比较各组一般资料、生化指标、CHA2DS2-VASc评分、心内超声指标及持续无心律失常时间等。结果 HbA_(1)c≥6.5%组年龄、BMI、FPG、TG、CHA2DS2-VASc评分、高血压、心力衰竭、DM患病率高于6%≤HbA_(1)c<6.5%、HbA_(1)c<6%组(P<0.05),持续无心律失常时间低于6%≤HbA_(1)c<6.5%、HbA_(1)c<6%组(P<0.05)。6%≤HbA_(1)c<6.5%、HbA_(1)c≥6.5%组LAD高于HbA_(1)c<6%组(P<0.05)。Kaplan-Meier生存曲线分析显示,各组导管消融术后,随着观察时间延长,无病生存率降低。Log-rank显著性检验显示,各组无心律失常生存曲线差异无统计学意义(P>0.05)。结论 HbA_(1)c与AF患者导管消融术预后相关,AF患者需加强术前HbA_(1)c管理。
Objective To investigate the effect of glycosylated hemoglobin A1c(HbA1c)on atrial fibrillation(AF)recurrence after catheter ablation.Methods 402 AF patients who underwent the first three-dimensional mapping guided catheter radiofrequency ablation treatment in the Cardiovascular Department of The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University from June 2015 to June 2021 were selected.According to HbA_(1)c levels,they were divided into HbA_(1)c<6%group(n=200),6%≤HbA_(1)c<6.5%group(n=122),and HbA_(1)c≥6.5%group(n=80).The general information,biochemical indicators,CHA2DS2-VASc score,cardiac ultrasound indicators and duration of absence of arrhythmias among different groups were compared.Results The age,BMI,FPG,TG,CHA2DS2-VASc scores,hypertension,HF and DM incidence rates in HbA_(1)c≥6.5%group were higher and the duration of no arrhythmia was lower than those in 6%≤HbA_(1)c<6.5%and HbA_(1)c<6%groups(P<0.05).The levels of LAD in 6%≤HbA_(1)c<6.5%and HbA_(1)c≥6.5%groups were higher than HbA_(1)c<6%group(P<0.05).Kaplan Meier survival curve analysis showed that the disease-free survival rate decreased in each group after catheter ablation with prolonged observation time.The Log-rank significance test showed that there was no significant difference in the arrhythmia-free survival curves between groups(P>0.05).Conclusion HbA1c is related to the prognosis of catheter ablation in AF patients,which suggests that blood glucose management should be strengthened before surgery.
作者
赵镇
邓聪颖
叶新华
张洁
ZHAO Zhen;DENG Congying;YE Xinhua(Department of Endocrinology,The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University,Changzhou 213000,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2024年第4期271-274,共4页
Chinese Journal of Diabetes
关键词
糖化血红蛋白
心房颤动
导管消融术
Glycosylated hemoglobin A1c
Atrial fibrillation
Catheter ablation
