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心房颤动射频消融术后复发影响因素的荟萃分析

  

  1. 新疆医科大学第一附属医院 综合心脏内科,新疆 乌鲁木齐  830000
  • 出版日期:2019-03-20 发布日期:2019-04-08
  • 通讯作者: 通信作者:木胡牙提,Email:muhuyati@163.com
  • 基金资助:
    国家自然科学基金资助项目---新疆地区哈萨克族、汉族心房颤动患者PD-1基因多态性及免疫调控研究(81560062)

Metaanalysis of factors influencing recurrence after radiofrequency ablation of atrial fibrillation

  1. Department of  Cardiology, the First Affiliated Hospital of Xinjiang  Medical University,  Urumqi 830000,  China
  • Online:2019-03-20 Published:2019-04-08
  • Contact: Corresponding authors: Muhuyati, Email: muhuyati@163.com

摘要: 目的   探讨心房颤动(房颤)患者病程,患有冠心病、糖尿病、高血压,左心房前后径(left atrial dimension,  LAD),左心室射血分数(left ventricular ejection fraction,  LVEF),身体质量指数(body mass index,BMI)对持续性房颤射频消融术后复发的预测价值。方法   计算机检索PubMed(1995-2018)、CBM(1995-2018)、中国知网(1958-2018)、万方数据库(1995-2018)、VIP(1989-2018)等数据库,对房颤患者射频消融术后,影响术后复发的危险因素的队列研究进行检索,并按照纳入与排除标准筛选文献、评价质量并提取资料后,采用RevMan5.3软件进行mta分析。结果   共纳入17个RCT,2827例患者。Meta分析结果显示:复发组房颤病程[MD=2.83,95%CI(2.48,3.19),P<0.05]、BMI[MD=0.84,95%CI(0.49,1.18),P<0.05]、左心房前后径[MD=2.63,95%CI(2.14,3.12),P<0.05]均大于未复发组;复发组LVEF低于未复发组[MD=-2.14,95%CI(-3.04,-1.25),P<0.05];患者术前是否患有冠心病[OR=0.75,95%CI(0.55,1.03),P>0.05]、糖尿病[OR=1.15,95%CI(0.86,1.53),P>0.05]、高血压病[OR=1.07,95%CI(0.75,1.54),P>0.05]与房颤射频消融术后复发无关系。结论  现有证据显示,房颤病程长、BMI数值大、左心房前后径长和LVEF低是房颤射频消融术后复发的危险因素,而患者术前是否患有冠心病、糖尿病、高血压病与房颤射频消融术后复发无关系。

关键词: 心房颤动, 射频消融术, 复发, 危险因素, meta分析

Abstract: Objective  To investigate  the predictive value of duration of disease,  coronary heart disease,  diabetes mellitus,  hypertension,  left atrial dimension (LAD),  left ventricular ejection fraction (LVEF),  body mass index (BMI) for recurrence after radiofrequency ablation of persistent atrial fibrillation(AF).Methods   The analysis of all related literatures in PubMed(19952018),  CBM(19952018),  CNKI(19582018),  WanfangData(19992018),  VIP(19892018) has been made. Selection criteria were the cohort study of risk factors affecting recurrence after radiofrequency ablation in patients with atrial fibrillation. All statistical tests were performed with RevMan5.3 software. Results  A total of 17 articles and 2827 patients were included. The results indicated that the duration of atrial fibrillation(MD=2.83,95%CI[2.48,3.19],P<0.05),  BMI (MD=0.84,95%CI[0.49,1.18],P<0.05)  and left atrial dimension (MD=2.63,95%CI[2.14,3.12],P<0.05)  were all greater in the recurrence group than in the nonrecurrence group. The LVEF of  recurrence group was lower than that of  nonrecurrence group (MD=-2.14,  95%CI[-3.04, -1.25],  P<0.05). Whether the patient had coronary heart disease (OR=0.75,  95%CI[0.55,  1.03],  P>0.05),  diabetes  (OR=1.15,  95%CI[0.86,  1.53],  P>0.05),  hypertension  (OR=1.07,  95%CI[0.75, 1.54], P>0.05)   had no relationship with recurrence after radiofrequency ablation of atrial fibrillation. Conclusion  Existing evidence shows that long course of atrial fibrillation,  high BMI,  long left atrial dimension and lower  LVEF are risk factors for recurrence after radiofrequency ablation of atrial fibrillation,  while whether patients have coronary heart disease,  diabetes and hypertension before surgery has no relationship with recurrence after radiofrequency ablation of atrial fibrillation.

Key words: atrial fibrillation, radiofrequency catheterablation, recurrence, risk factors, Metaanalysis