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投稿时间：2025-08-12 网络发布日期：2026-03-04
投稿时间：2025-08-12 网络发布日期：2026-03-04
中文摘要: 目的 探讨左心房容积指数（LAVI）与首次急性心肌梗死（AMI）后患者新发心房颤动（NOAF）关系的临床意义。方法 回顾性纳入2022年8月至2024年7月于扬州大学附属淮安医院心内科就诊的214例AMI患者，根据住院期间是否发生NOAF分为NOAF组（32例）和非NOAF组（182例）。所有患者入院后均行经皮冠状动脉介入（PCI）治疗。对比分析两组间临床资料、超声心动图特征等。采用logistic回归方程分析AMI患者发生NOAF的相关因素，使用受试者工作特征（ROC）曲线评价LAVI对AMI患者发生NOAF的预测价值。结果 与非NOAF组比较，NOAF组年龄较大、入院时心率较快，二尖瓣E峰及LAVI较高，而左室射血分数较低，差异均有统计学意义（P<0.05）。多因素logistic回归分析显示，年龄大、入院时心率快、LVEF低、二尖瓣E峰和LAVI高是首次AMI患者发生 NOAF 的独立危险因素（P<0.05），其中 LAVI 与 AMI 患者 NOAF 具有最强的相关性（OR=1.175，95%CI：1.099~1.257，P<0.01）。ROC曲线分析结果显示，LAVI预测AMI患者发生NOAF的曲线下面积为0. 814（95%CI：0.740~0.888，P<0.01），最佳截断值为 27.88 mL/m2，敏感度为 87.50%，特异度为 60.40% 。高 LAVI 组住院期间NOAF发生率高于低LAVI组［28.00%（28/100）vs 3.51%（4/114），χ2=25.130，P<0.01］。结论 LAVI是首次AMI患者发生NOAF的独立预测因素。随着LAVI的增加，NOAF的发生率逐渐升高。
Abstract:Objective To investigate the clinical significance of July relationship between left atrial volume index（LAVI）and new-onset atrial fibrillation（NOAF）in patients with first attack acute myocardial infarction（AMI）.Methods A total of 214 AMI patients admitted to Cardiovascular Department of Huai’an Hospital Affiliated to Yangzhou University from August 2022 to July 2024 were enrolled retrospectively.They were divided into NOAF group（32 cases）and non - NOAF group（182 cases） according to whether NOAF occurred during hospitalization. All individuals underwent percutaneous coronary intervention（PCI）after admission，and analyzed whether there were differences in clinical data and echocardiographic characteristics between the two groups. Logistic regression equation was used to analyze the factors related to the occurrence of NOAF in AMI patients，and receiver operating characteristic（ROC）curve was used to evaluate the predictive value of LAVI on the occurrence of NOAF in AMI patients. Results Compared with the non-NOAF group，patients in NOAF group were older，had faster heart rate at admission，higher mitral E peak and LAVI，and lower left ventricular ejection fraction，with statistically significant differences（P<0.05）. Multivariate logistic regression analysis showed that older age，faster heart rate at admission，lower LVEF，higher mitral E peak，and higher LAVI were independent risk factors for NOAF in patients with first attack AMI（P<0.05）. Among these，LAVI had the strongest correlation with NOAF in AMI patients（OR=1.175，95%CI：1.099-1.257，P<0.01）. ROC curve analysis results showed that the area under the curve of LAVI for predicting the occurrence of NOAF in AMI patients was 0.814（95%CI：0.740-0.888，P<0.01），with the optimal cutoff value being 27.88 mL/m2，sensitivity of 87.50%，and specificity of 60.40%. During hospitalization，the incidence of NOAF in high LAVI group was higher than that in low LAVI group［28.00%（28/100）vs 3.51%（4/114），χ2=25.130，P<0.01］.Conclusion LAVI is an independent predictor of NOAF in patients with first attack AMI. As LAVI increases，the incidence of NOAF gradually increases.
keywords: Acute myocardial infarction Atrial fibrillation,new-onset Left atrial volume index Left ventricular ejection fraction Mitral E peak
文章编号： 中图分类号：R541.7+5 R541.4 文献标志码：A
基金项目:淮安市卫生健康科研项目（HAWJ202403）
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引用文本：
刘洲， 丁小闯， 朱悦知， 雍辉.左心房容积指数预测首次急性心肌梗死患者新发心房颤动的价值[J].中国临床研究,2026,39(2):267-271.
刘洲， 丁小闯， 朱悦知， 雍辉.左心房容积指数预测首次急性心肌梗死患者新发心房颤动的价值[J].中国临床研究,2026,39(2):267-271.