急性心肌梗死后新发心房颤动的危险因素分析

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[中图分类号] R542.2 [文献标志码] A doi：10.1712/ms.2096-532.2025.61.053

[文章编号] 2096-532（2025）02-019-05

[Abstract] Objective Toinvestigatetheasociationofnew-onsetatrialfibrilation （NOAF）afteracutemyocardialinfarction（AMI）withmeanplateletvolume-to-lymphocyteratio（MPVLR），atrialfibrilationrecurence，readmision，andmajoradversecardiovascularandcerebrovascularevents（MAC E）. Methods Atotalof652patientswhounderwentemergencypercutaneouscoronaryinterventionforAMIwereenroled，andacordingtothepresenceorabsenceofatrialfibrilationduringtheacute stageofAMI，theyweredividedintoNOAFgroupandnon-NOAFgroup.TheLogisticregresionanalysiswasusedtoinvestigate theinfluenceofMPVLRontheincidencerateofNOAFafterAMI，andthereceiveroperatingcharacteristic（ROC）curvewasused toanalyzethevalueofMPVLRinpredictingNOAF.Thepatientswerefolowedupfor2yearsafterdischarge，andthetwogroups werecomparedintermsofMAC E，theincidencerateofatrialfibrilation，andmortalityrate.Results Amongthe652patients withAMI，542 83.1% ）hadnoatrialfibrilation，and10 16.9% ）experiencedNOAF.ThemultivariateLogisticregresionanalysisshowedthatMPVLR ⋅OR=1.343，95%CI=1.188-1.518，P<0.001） ）wasanindependentpredictivefactorforNOAFinAMI patients.MPVLRhadanareaundertheROCcurve（AUC）of0.675，withasensitivityof 70.0% ，aspecificityof 53.0% ，anda cut-ofvalueof6.198inpredictingNOAF，andthecombinationofMPVLRandleftatrialanteroposteriordiameterhadabeter predictiveefect，withanAUCof 0.784 ，asensitivityof 84.5% ，andaspecificityof 56.6% .ThepatientswithNOAFafterAMI tendedtohaveaporerprognosis，andthepatientswithAMIandNOAFhadhigherprobabilitiesofatrialfibrilation，ischemic stroke，adversecardiovascularevents，readmision，anddeath （χ2=4.83-42.12，P<0.05） ），andsuchpatientshadnosignificant benefitsfromanticoagulanttherapy （P>0.05） ）.Conclusion MPVLRisanindependentriskfactorforNOAFafterAMI，and MPVLRcombinedwithleftatrialanteroposteriordiameterhasabeterpredictiveefect.PatientswithNOAFafterAMItendto havea or ronosis.

[Keywords] myocardialinfarction;atrialfibrilation;riskfactors;prognosis

《中国心血管健康与疾病报告 》指出，我国冠心病的死亡率持续增高，冠心病已成为我国死亡率居首位的疾病[1]，急性心肌梗死（ ）是其重要分型[2]。（剩余9176字）