临床医学工程2008年第l5卷第12期ClinicalMedicalEngineering2008,15(12)血液透析患者新发房颤的临床分析许雪强,张波,俞香宝,朱亚梅,毛慧娟,邢昌赢(南京医科大学第一附属医院肾科,江苏南京210029)·论著一临床医学·【摘要】目的:房颤是否增加维持性透析患者死亡率尚无定论。我们回顾分析了维持性血液透析患者的房颤发生率,并对其临床相关因素进行了探讨。方法:观察本中心2005年1月到2007年6月维持性血液透析超过3个月的患者,记录他们的年龄,透析方式,房颤发生情况及血红蛋白维持水平。结果:168例患者中,121N新发房颤,发生率为7.14%,年龄大于55岁的患者共90例,房颤发生率为11.45%,显著高于年龄小于55岁的患者。透析龄大于4年的房颤的发生率为11.11%,房颤患者和非房颤患者血红蛋白水平无明显差异。非房颤患者中有25例发生心梗或脑梗,发生率为15.15%,而房颤患者中发生两例脑梗,发生率为16.67%。结论:1.透析患者的房颤发生率高于普通人群;2.随着年龄的增加房颤的发病率增加,55岁以上的房颤发病率明显升高;3.随着透析年限的增加房颤的发病率也增加,血液透析4年以上房颤的发病率明显升高。【关键词】血液透析;房颤中图分类号:R541.7文献标识码:A文章编号:1674—4659(2008)12—0033—03ARetrospectiveAnalysisofNewAtrialFibrellationinHemodialysisPatientsXUXueqiang,ZHANGBo,YuXiangbao,ZHUYamei,MAOHuijuan,XINGChangying(DepartmentofNephrology,TheFirstAfiliatedHospitalofNanjiingMedicalUniversity,Nanjing,Jiangsu210029China)[Abstract]Objective:Whetheritistruethatatrialfibrellationincreasesthemortalityinmaintainedhemodialysispatientsre-mainscontroversia1.Wemadearetrospectiveanalysisoftheincidenceofatrialfibrillationandrelativeclinicalfactorsamongthehemo—dialysispatientsinasinglecenter~Methods:WeobservedthepatientswhocamefromourcenterfromJanuary2005toJuly2007,theyallhadahistoryofhemodialysisformorethan3months.Theage,dialysisplan,atrialfibrillationincidence,andhemoglobinlevelwererecorded.Results:12patients(7.14%)hadanewoccurrenceofatrialfibrillation.Ofpatientsolderthan55yearsold,90patients(】】.45%)hadatrialfibrillation,significantlyhigherthanthepatientsyoungerthan55yearsold.Theincidenceofatrialfibrillationinthedialysispa-tientsformorethan4yearswas11.11%.Therewasnosignificantdiferenceinhemoglobinlevelbetweenatrialfibrillationandnon—atrialfibrillationpatients.Amongthenon—atrialfibrillationpatients,25patients(15.15%)hadmyocardialinfarctionorbraininfarction,while2patients(16.67%)hadbraininfarctionamongtheatrialfibrillationpatients.Conclusion:1.Dialysispatientshadahigherincidenceofatrialfibrillationthangeneralpopulation.2.Theincidenceofatrialfibrillationincreasedwiththeincreaseofage,significantlyhigherinthepatientsolderthan55yearsold.3.Withtheincreaseofdialysisage,theincidenceofatrialfibrillationincreasedsignificantlyhigherinthepatientswithlongerthan4yearsofdialysisage.【keywords]hemodialysis;atrialfibrillation终末期肾病(ESRD)的年发病率目前约为万分之一,随着社会发展及疾病谱的变化,发病率和患病率还将逐年增加。美国2000年统计有37万尿毒症患者,至2OlO年预计将达到68万人[1]。随着人口的老龄化,65岁以上的发病率是45岁以下的10倍[2]。我国目前尚缺乏慢性肾脏病的流行病学调查资料,从局部小样本调查数据来看,我国的CKD患病率与西方国家相似,也意味着我国目前可能有100万尿毒症患者需要接受透析治疗[1]。心房颤动(atrialfibrillation,AF)是临床最常见的心律失常之一。国内外关于房颤的流行病学资料均较少,国作者简介:许雪强(1978一),男,江苏宜兴人;张波(1978一),男,江苏无锡人;俞香宝(1963一),男,江苏南京人;通讯作者:邢昌...