[1]景莉娟,陶海龙#,李 凌,等.HDL-C与非瓣膜性房颤左心房血栓形成的关系[J].郑州大学学报(医学版),2017,(02):209-212.[doi:10.13705/j.issn.1671-6825.2017.02.026]
 JING Lijuan,TAO Hailong,LI Ling,et al.Relationship between high-density lipoprotein cholesterol and left atrial thrombus in nonvalvular atrial fibrillation patients[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(02):209-212.[doi:10.13705/j.issn.1671-6825.2017.02.026]
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HDL-C与非瓣膜性房颤左心房血栓形成的关系()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年02期
页码:
209-212
栏目:
应用研究
出版日期:
2017-03-15

文章信息/Info

Title:
Relationship between high-density lipoprotein cholesterol and left atrial thrombus in nonvalvular atrial fibrillation patients
作者:
景莉娟陶海龙#李 凌白中乐孟 哲王梦雨
郑州大学第一附属医院心血管内科 郑州 450052
Author(s):
JING Lijuan TAO Hailong LI Ling BAI Zhongle MENG Zhe WANG Mengyu
Department of Cardiology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052
关键词:
心房颤动 高密度脂蛋白胆固醇 左心房 血栓
Keywords:
atrial fibrillation high-density lipoprotein cholesterol left atrial thrombus
分类号:
R541.75
DOI:
10.13705/j.issn.1671-6825.2017.02.026
摘要:
目的:探讨血浆高密度脂蛋白胆固醇(HDL-C)与非瓣膜性房颤左心房血栓形成的关系。方法:回顾性分析拟行房颤射频消融术的非瓣膜性房颤患者473例,经食管超声心动图检查左心房是否有血栓形成后分为:血栓组(n=60例)、非血栓组(n=413例)。比较两组患者一般资料、CHA2DS2-VASc积分、实验室检查(包括HDL-C)、心脏彩超指标的差异。结果:高CHA2DS2-VASc积分(OR=1.649,95%CI:1.238~2.197,P=0.001)、持续性房颤(OR=3.424,95%CI:1.718~6.821,P<0.001)是非瓣膜性房颤左心房血栓形成的独立危险因素,而HDL-C(OR=0.299,95%CI:0.097~0.924,P=0.036)是其形成的独立保护因素。CHA2DS2-VASc积分预测房颤左心房血栓形成的ROC曲线下面积为0.717(95%CI:0.671~0.759,P<0.001),HDL-C水平联合CHA2DS2-VASc积分、房颤类型预测房颤左心房血栓形成的ROC曲线下面积为0.791(95%CI:0.749~0.829,P<0.001)。结论:低HDL-C水平是左心房血栓形成的高危因素。HDL-C水平联合CHA2DS2-VASc积分、房颤类型预测房颤左心房血栓形成优于CHA2DS2-VASc积分。
Abstract:
Aim: To investigate the relationship between high-density lipoprotein cholesterol(HDL-C)and left atrial thrombus in nonvalvular atrial fibrillation(AF)patients.Methods: A total of 473 patients with nonvalvular AF who were admitted in our department for radiofrequency catheter ablation were enrolled. The patients were allocated into thrombus group(n=60)and non-thrombus group(n=413)according to transesophageal echocardiography. All baseline clinical characteristics, CHA2DS2-VASc score, laboratory examination results(HDL-C included)and echocardiographic parameters were analyzed.Results: Higher CHA2DS2-VASc score(OR=1.649,95%CI:1.238-2.197,P=0.001), persistent AF(OR=3.424,95%CI:1.718-6.821,P<0.001)were the independent risk factors for left atrial thrombus, while HDL-C(OR=0.299,95%CI:0.097-0.924,P=0.036)was the independent protective factor. ROC curves showed that the AUC of CHA2DS2-VASc score to predict left atrial thrombus in nonvalvular atrial fibrillation patients was 0.717(95%CI:0.671-0.759,P<0.001), and the AUC of HDL-C combined with CHA2DS2-VASc score and persistent AF was 0.791(95%CI:0.749-0.829,P<0.001).Conclusion: Low HDL-C level is a high risk factor for left atrial thrombus. Combining HDL-C level with CHA2DS2-VASc score and persistent AF to predict left atrial thrombus in nonvalvular atrial fibrillation patients is superior to CHA2DS2-VASc score.

参考文献/References:

[1] FANG MC,GO AS,CHANG Y,et al.Comparison of risk stratification schemes to predict thromboembolism in People with nonvalvular atrial fibrillation[J].J Am Coll Cardiol,2008,51(8):810
[2] 马乐乐,黎明江.心房颤动患者血浆高密度脂蛋白胆固醇水平变化的临床研究[J].海南医学,2011,22(22):4
[3] VEMMOS KN,TAKIS CE,GEORGILIS K,et al.The athens stroke registry:results of a five-year hospital-based study[J].Cerebrovasc Dis,2000,10(2):133
[4] 李延广,时向民,林琨,等.心房颤动血栓形成机制研究进展[J].心血管病学进展,2015,36(6):691
[5] ANNOURA M,OGAWA M,KUMAGAI K,et al.Cholesterol paradox in patients with paroxysmal atrial fibrillation[J].Cardiology,1999,92(1):21
[6] ALONSO A,YIN X,ROETKER NS,et al.Blood lipids and the incidence of atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis and the Framingham Heart Study[J].J Am Heart Assoc,2014,3(5):e001211
[7] JANG MJ,CHOI WI,BANG SM,et al.Metabolic syndrome is associated with venous thromboembolism in the Korean population[J].Arterioscler Thromb Vasc Biol,2009,29(3):311
[8] SAMANTHA A,MARIA M,MATTHEW A,et al.HDL cholesterol and stroke risk:the multi-ethnic study of atherosclerosis[J].Atherosclerosis,2015,243(1):314
[9] MA X,JI XM,FU P,et al.Coexistence of high fibrinogen and low high-density lipoprotein cholesterol levels predicts recurrent cerebral venous thrombosis[J].Chin Med J,2015,128(13):1732
[10]高秀玲,崔朝勃,袁雅冬.高密度脂蛋白胆固醇与肺血栓栓塞症的相关性[J].中华结核和呼吸杂志,2010,33(4):311
[11]GRIFFIN JH,KOJIMA K,BANKA CL,et al.High-density lipoprotein enhancement of anticoagulant activities of plasma protein S and activated protein C[J].J Clin Invest,1999,103(2):219
[12]REN S,SHEN GX.Impact of antioxidants and HDL on glycated LDL-induced generation of fibrinolytic regulators from vascular endothelial cells[J].Arterioscler Thromb Vasc Biol,2000,20(6):1688
[13]BRUINS P,TE VELTHUIS H,YAZDANBAKHSH AP,et al.Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia[J].Circulation,1997,96(10):3542
[14]TVEIT A,SELJEFLOT I,GRUNDVOLD I,et al.Effect of candesartan and various inflammatory markers on maintenance of sinus rhythm after electrical cardioversion for atrial fibrillation[J].Am J Cardiol,2007,99(11):1544
[15]BREITENSTEIN A,GLANZMANN M,FALK V,et al.Increased prothrombotic profile in the left atrial appendage of atrial fibrillation patients[J].Int J Cardiol,2015,185:250
[16]KOSTAPANOS MS,LIBEROPOULOS EN,GOUDEVENOS JA,et al.Do statins have an antiarrhythmic activity?[J].Cardiovasc Res,2007,75(1):10

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备注/Memo

备注/Memo:
#通信作者,男,1976年5月生,博士,副教授,副主任医师,研究方向:心脏电生理,E-mail:hailongtao@163.com
更新日期/Last Update: 2017-03-20