2025 年第 2 期 第 20 卷

合并慢性阻塞性肺疾病对心房颤动患者血栓事件发生以及射频消融术后复发的影响

The impact of chronic obstructive pulmonary disease on the occurrence of thrombotic events and recurrence after radiofrequency ablation in patients with atrial fibrillation

作者：牟依赛1赵久平2曹勇1孙智娜3

英文作者：Mou Yisai1 Zhao Jiuping2 Cao Yong1 Sun Zhina3

单位：1青海红十字医院心血管科，西宁810000；2济宁医学院附属医院心内科，济宁272067；3青海红十字医院呼吸与危重症医学科，西宁810000

英文单位：1Department of Cardiovascular Qinghai Red Cross Hospital Xining 810000 China; 2Department of Cardiology Affiliated Hospital of Jining Medical University Jining 272067 China; 3Department of Respiratory and Critical Care Medicine Qinghai Red Cross Hospital Xining 810000 China

关键词：心房颤动；慢性阻塞性肺疾病；血栓事件；射频消融术；复发

英文关键词：Atrialfibrillation；Chronicobstructivepulmonarydisease；Thromboticevents;Radiofrequencyablation;Recurrence

• 摘要：

• 目的 探讨合并慢性阻塞性肺疾病（COPD）对心房颤动患者血栓事件发生以及射频消融术后复发的影响。方法 选择2020年1月至2024年1月青海红十字医院收治的80例合并COPD的心房颤动患者（COPD组）和80例未合并COPD的心房颤动患者（对照组）。统计2组血栓事件发生情况和心房颤动血栓危险度（CHA2DS2-VASc）评分，所有患者接受射频消融术，根据术后复发情况将心房颤动患者分为复发组和无复发组。分析影响心房颤动患者射频消融术后复发的因素。结果 COPD组总血栓事件发生率、CHA2DS2-VASc评分≥2分比例、术后复发率均高于对照组［20.0%(16/80)比8.8%（7/80）、22.5%（18/80）比10.0%（8/80）、53.8%（43/80）比26.2%（21/80）］（均P＜0.05）。160例患者共复发64例，未复发96例。复发组体重指数、合并2型糖尿病比例、合并COPD比例高于未复发组，心房颤动病程、左心房前后径长于未复发组，左心室射血分数低于未复发组（均P＜0.05）。心房颤动病程较长、合并COPD是心房颤动患者射频消融术后复发的危险因素（比值比=3.762、2.656，均P＜0.001）。结论 合并COPD的心房颤动患者血栓事件发生率和射频消融术后复发率均较高，合并COPD是心房颤动患者射频消融术后复发的危险因素。

• Objective To investigate the impact of chronic obstructive pulmonary disease (COPD) on the occurrence of thrombotic events and recurrence after radiofrequency ablation in patients with atrial fibrillation. Methods Totally 80 atrial fibrillation patients with COPD (COPD group) and 80 atrial fibrillation patients without COPD (control group) admitted to Qinghai Red Cross Hospital from January 2020 to January 2024 were selected.  The occurrence of thrombotic events and the score of atrial fibrillation thrombosis risk-VASc (CHA2DS2-VASc) in the two groups were recorded. All patients underwent radiofrequency ablation. The patients were divided into recurrence group and non-recurrence group according to the recurrence of atrial fibrillation after radiofrequency ablation. The factors affecting the recurrence of atrial fibrillation after radiofrequency ablation were analyzed. Results The total incidence of thrombotic events, the proportion of CHA2DS2-VASc score ≥2, and the postoperative recurrence rate in the COPD group were higher than those in the control group ［20.0%(16/80) vs 8.8%（7/80）, 22.5%（18/80） vs 10.0%（8/80）, 53.8%（43/80） vs 26.2%（21/80）］(all P＜0.05). A total of 64 patients had recurrence and 96 patients had no recurrence. The body mass index, the proportion of type 2 diabetes mellitus and COPD in the recurrence group were higher than those in the non-recurrence group. The duration of atrial fibrillation and the left atrial anteroposterior diameter were longer than those in the non-recurrence group, and the left ventricular ejection fraction was lower in the recurrence group than that in the non-recurrence group (all P＜0.05). A longer course of atrial fibrillation and COPD were the risk factors for recurrence of atrial fibrillation after radiofrequency ablation （odds ratio=3.762, 2.656, both P＜0.001）. Conclusions The incidence of thrombotic events and the recurrence rate after radiofrequency ablation of atrial fibrillation in patients with COPD are higher. COPD is a risk factor for the recurrence of atrial fibrillation after radiofrequency ablation.