中老年心房颤动62例冠状动脉造影的临床分析

目的：采用冠状动脉造影检查评估中老年心房颤动与冠心病的关系。方法收集我院2009年1月~2013年12月间未明确病因的中老年心房颤动患者定为研究组，并选择同期住院非冠心病房颤患者62例定为对照组，分析研究组危险因素，并对所有患者进行冠脉造影检查，观察两组患者与冠心病关系。结果高血压患房颤发生率明显高于其他因素发生率，差异具有统计学意义（P〈0.05）；研究组持续性房颤为45.45%，明显高于本组阵发性房颤16.17%（P〈0.05），与对照组持续性房颤对比，差异无统计学意义（P〉0.05）；缺血性ST-T改变为47.37%，与本组非ST-T改变及对照组ST-T改变对比，差异具有统计学意义（P〈0.05）。结论中老年为心房颤动高发人群，如有危险因素或并发危险因素，未明确病因合并持续性房颤且ST-T改变患者，应考虑为冠心病引发，但不能确诊，仍应以冠脉造影检查明确诊断。

Clinical analysis on coronary angiography in 62 middle-aged and elderly patients with atrial fibrillation

Objective To evaluate the association between atrial fibrillation and coronary heart disease in middle-aged and elderly patients based on coronary angiography. Methods Middle-aged and elderly patients with unknown atrial fibrillation treated in our hospital from Jan 2009 to Dec 2013 were selected as the study group. 62 patients with non-coronary artery disease induced atrial fibrillation hospitalized in our hospital at the same period were selected as the control group. The risk factors of the study group were analyzed. Coronary angiography was conducted on all patients to observe the association between these patients and coronary heart disease. Results The patients with hypertension had significantly higher incidence of atrial fibrillation than patients with other diabetic disorders, with statistical signifi-cance （P〈0.05）. The incidence of persistent atrial fibrillation in the study group was 45.45%, significantly higher than paroxysmal atrial fibrillation （16.17%） in the study group（P〈0.05）; but without statistical difference from persistent a-trial fibrillation in the control group（P〉0.05）. The incidence of ischemic ST-T change in the study group was 47.37%, with significant difference from non-ST-T change in the study group and ST-T change in the control group （P〈0.05）. Conclusion Middle-aged and elderly populations have high risk of atrial fibrillation. With presence of risk factors or concomitant risk factors, patients with unknown persistent atrial fibrillation and ST-T change should be considered as induced by coronary heart disease. If unable to confirm, coronary angiography should be used to confirm diagnosis.