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性别对心房颤动伴慢性心力衰竭患者全因死亡风险的影响
作者:唐小霞  宗超  梁力  李婷婷 
单位:徐州市肿瘤医院, 江苏 徐州 221000
关键词:心房颤动 慢性心力衰竭 性别 全因死亡率 
分类号:R541.7;R541.6
出版年·卷·期(页码):2020·39·第一期(41-46)
摘要:

目的:探讨性别对合并心房颤动(房颤)慢性心力衰竭(心衰)患者全因死亡风险的影响。方法:连续入选2014年1月至2017年1月于徐州市肿瘤医院明确诊断房颤伴慢性心衰患者共232例,记录患者的基线资料及治疗情况,并根据患者性别将其分为男性组(n=105)和女性组(n=127)两组。研究终点为患者的全因死亡。采用Kaplan-Meier曲线及Log-rank检验比较不同性别患者的累积生存率,通过构建多因素Cox回归模型分析患者全因死亡的危险因素。结果:中位随访36个月,41例患者死亡,不同性别患者的累积生存率差异有统计学意义(女性 vs 男性为89.8% vs 72.3%,Log-rank P=0.001)。多因素Cox回归分析显示男性(HR 2.63, 95%CI 1.23~5.56,P=0.012)、合并慢性肾功能不全(HR 2.15, 95%CI 1.02~4.53,P=0.044)、左心室舒张末期内径增大(HR 1.08, 95%CI 1.01~1.15,P=0.018)以及N端脑钠肽前体浓度升高(HR 1.59; 95%CI 1.04~2.43;P=0.031)是患者全因死亡的独立危险因素。结论:男性、合并慢性肾功能不全、左心室舒张末期内径增大、N端脑钠肽前体升高是房颤合并心衰患者全因死亡的独立危险因素。

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