| Objectives Combined with the clinical characteristics of elderly patients with non-valvular atrial fibrillation(nvaf),to explore the related factors affecting the occurrence and development of non-valvular atrial fibrillation in the elderly.Methods From October 2017 to April 2019,173 patients with nvaf aged ?60 years who were hospitalized in the department of geriatrics and department of cardiology of affiliated hospital of north China university of science and technology were selected as the case group,and 174 patients with sinus rhythm aged ?60 years who were hospitalized in the same period with the case group were selected as the control group.Then the case group was divided into <75 years old group and ?75 years old group according to age,paroxysmal atrial fibrillation(AF)group,non-paroxysmal af group(persistent / long-term persistent / permanent af)according to af type.Collect and record the clinical data of all the subjects,including the history of related diseases,blood routine,blood lipid levels,uric acid,homocysteine,cardiac ultrasound,vascular ultrasound indexes of lower extremities and neck,etc.Collate all the data collected,create a database and use SPSS 22.0 software to analyze the data.The measurement data are expressed by mean ± standard deviation,and the comparison between groups is expressed by t-test,the constituent ratio of counting data is calculated,and chi-square test or Fisher exact test is used for comparison between groups.The clinical characteristics of elderly patients with nvaf were summarized,and the related factors were screened by univariate analysis,and then the factors affecting the occurrence and development of nvaf were analyzed by multivariate logisitic regression.Results 1 Univariate analysis showed that there was no significant difference in age and sex between the case group and the control group(P>0.05).Compared with the basic diseases,patients in the case group had significantly higher rates of peripheral arterial disease(PAD),coronary heart disease,hypertension,cerebral infarction,heart failure,and diabetes than the control group.In terms of blood lipid level,the levels of triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and apolipoprotein B(apoB)in the case group were lower than those in the control group,while the level of total cholesterol(TC)in the case group was higher than that in the control group.The levels of left atrial diameter(LAD)and interventricular septal thickness(IVST)in the case group were higher than those in the control group,while the left ventricular ejection fraction(LVEF)was lower than that in the control group.Compared with other indexes,the levels of body mass index(BMI),uric acid,creatinine and homocysteine(HCY)in the case group were higher than those in the control group,while the level of white blood cell count(WBC)in the case group was lower than that in the control group.There were significant differences in the above-mentioned indexes among the groups(P<0.05).Correlation studies showed that patients with PAD,coronary heart disease,hypertension,cerebral infarction,heart failure and diabetes,increased levels of TG,LDL-C,HDL-C and apoB,decreased LVEF,increased LAD and IVST,and increased levels of BMI,uric acid,creatinine and HCY were associated with nvaf in the elderly.Multivariate logisitic regression analysis showed that history of coronary heart disease,hypertension and history of heart failure,increased LAD,high TC and high HCY were risk factors for nvaf in the elderly(The OR values were 1.732,1.678,3.570,2.436,3.690,2.704,P<0.05).High TG and high apolipoprotein B(apoB)were protective factors for the occurrence of nvaf in the elderly(The OR values were 0.362,0.086,P<0.05).2 Univariate analysis showed that nvaf group aged <75 years old and nvaf group aged ?75 years old,according to the comparison of basic diseases,the proportion of PAD,coronary heart disease and cerebral infarction in the nvaf group aged <75 years old was significantly lower than that in the nvaf group aged ?75 years old.Compared with other indexes,the proportion of males and the level of BMI in the <75 years old nvaf group were higher than those in the ?75 years old nvaf group,while the levels of creatinine,urea,HCY and percentage of neutrophils(NE%)in the <75 years old nvaf group were lower than those in the ?75 years old nvaf group.There were significant differences in the above-mentioned indexes among the groups(P<0.05).There was no significant difference in blood lipid levels and echocardiographic indexes between <75 years old nvaf group and ?75 years old nvaf group(P>0.05).Multivariate logisitic regression analysis showed that the proportion of female patients with nvaf aged ?75 years old was higher and BMI was lower,and the characteristics were statistically significant(P<0.05).3 Univariate analysis showed that elderly non-valvular paroxysmal atrial fibrillation group and elderly non-valvular non-paroxysmal atrial fibrillation group,compared with the basic diseases,the proportion of heart failure in the elderly non-valvular paroxysmal atrial fibrillation group was significantly lower than that in the elderly non-valvular non-paroxysmal atrial fibrillation group.The levels of TC and apolipoprotein A(apoA)in elderly patients with non-valvular paroxysmal atrial fibrillation were higher than those in elderly patients with non-valvular non-paroxysmal atrial fibrillation.In comparison of echocardiographic indexes,the levels of LAD and IVST in elderly patients with non-valvular paroxysmal atrial fibrillation were lower than those in elderly patients with non-valvular non-paroxysmal atrial fibrillation,while the level of LVEF was higher than that in elderly patients with non-valvular non-paroxysmal atrial fibrillation.Compared with other indexes,the level of uric acid in elderly non-valvular paroxysmal atrial fibrillation group was significantly lower than that in elderly non-valvular non-paroxysmal atrial fibrillation group.There were significant differences in the above-mentioned indexes among the groups(P<0.05).Multivariate logisitic regression analysis showed that compared with the paroxysmal af group,elderly patients with nvaf had an increased LAD and a higher risk of developing nvaf combined with heart failure(P<0.05).Conclusions 1 Multiple diseases often coexist in elderly patients with non-valvular atrial fibrillation,elderly patients with nvaf should strengthen co-morbidity management.Coronary heart disease,hypertension,heart failure,high levels of TC and high levels of HCY are all risk factors for the occurrence of elderly nvaf.High TG and high apoB are protective factors for the occurrence of elderly nvaf.2 In the elderly patients with nvaf aged ?75 years old,the proportion of females was higher and the BMI was lower.3 Elderly patients with nvaf,increased LAD and heart failure are at higher risk for prolonged duration of nvaf.Figure 0;Table 20;Reference 159... |
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