摘要
目的探讨血液透析患者相关心房颤动(atrial fibrillation,AF)的发生情况,并对AF发生的影响因素进行分析。方法选择2018年1月至2020年5月在郑州第七人民医院行维持性血液透析的125例患者作为研究对象,记录所有患者血液透析1个月内AF的发生情况,检测透析相关指标和电解质指标,并使用ROC分析预测指标的准确性。结果在1个月总计1575人次的透析治疗中,AF发生67人次,发生率为4.25%,52例患者发生透析相关AF,占比达41.60%;透析治疗的前2h内,AF发生4人次(占比5.97%),透析治疗的后2h内,AF发生35人次(占比52.24%),透析治疗结束后4 h内,AF发生28人次(占比41.79%);AF组血透超滤率高于非AF组,并且透析前后血钾、血镁含量均低于非AF组,差异具有统计学意义(P<0.05);通过ROC分析发现,透析前血钾指标AUC为0.937、透析后血钾指标AUC为0.939,是预测AF发生的较好指标,其中透析前血钾含量<4.25 mmol/L,透析后血钾含量<3.45 mmol/L时,预测AF发生最准确。结论血液透析相关AF发生率较高,发生时间多集中在透析治疗的后2h和透析治疗结束后4h内,血透超滤量、血钾和血镁等电解质含量与AF发生存在相关性,其中透析前后血钾指标是预测血液透析相关AF发生的较好指标。
Objective To explore the occurrence of atrial fibrillation(AF)in hemodialysis patients,and analyze the influencing factors of AF.Methods A total of 125 patients who underwent maintenance hemodialysis in Zhengzhou Seventh People’s Hospital from January 2018 to May 2020 were selected as the research objects.The occurrence of AF in all patients within 1 month of hemodialysis was record.Dialysis-related indexes and electrolyte indexes of research objects were detected,and the indexes were analyzed and predicted the accuracy by ROC curve.Results In a total of 1575 dialysis treatments for 1 month,67 person-times developed AF,the incidence rate was 4.25%.And 52 patients developed dialysis-related AF,accounting for 41.60%.Within the first 2 hours of dialysis treatment,4 person-times developed AF(accounting for 5.97%),within the last 2 hours of dialysis treatment,35 person-times developed AF(accounting for 52.24%)and within 4 hours after dialysis treatment,28 person-times developed AF(accounting for 41.79%).The hemodialysis ultrafiltration rate in the AF group was significantly higher than that of the non-AF group,and the levels of blood potassium and blood magnesium before and after dialysis were significantly lower than those of the non-AF group(P<0.05).Through ROC curve analysis,it was found that the AUC value of the blood potassium before dialysis was 0.937,and the AUC value of the blood potassium after dialysis was 0.939,which were good indicators for predicting the occurrence of AF.When the blood potassium content before dialysis was less than 4.25 mmol/L,and the blood potassium content after dialysis was less than 3.45 mmol/L,the most accurate prediction for the occurrence of AF.Conclusion The incidence of hemodialysis-related AF was relatively high,and the occurrence time was mostly concentrated within the last 2 hours of dialysis treatment and within 4 hours after dialysis treatment.Hemodialysis ultrafiltration,and the electrolyte indicators of blood potassium and blood magnesium were correlated with the occurrence of AF.Blood potassium index before and after dialysis was a good indicator for predicting the occurrence of hemodialysis-related AF.
作者
刘金瑞
LIU Jin-rui(Kidney Transplant Nephrology Clinic,Zhengzhou the Seventh People's Hospital,Zhengzhou 450016,China)
出处
《医药论坛杂志》
2021年第15期35-38,共4页
Journal of Medical Forum
基金
河南省医学科技攻关计划项目(2018020863)
