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术前低白蛋白血症、血尿素氮和肌酐水平对非体外循环冠状动脉旁路移植术患者术后心房颤动的影响研究。

Investigation of the Effect of Preoperative Hypoalbuminemia, Blood Urea Nitrogen and Creatinine Levels on Postoperative Atrial Fibrillation on Off-Pump Coronary Bypass Surgery Patients.

机构信息

Department of Cardiovascular Surgery, Health Science University Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey.

出版信息

Heart Surg Forum. 2020 Sep 8;23(5):E641-E646. doi: 10.1532/hsf.3163.

DOI:10.1532/hsf.3163
PMID:32990567
Abstract

BACKGROUND

Postoperative atrial fibrillation (PoAF) is one of the most common complications to occur after open heart surgery. It has been shown that hypoalbuminemia accompanies some cardiovascular disorders. The present study evaluates the effects of pre-procedural albumin, blood urea nitrogen (BUN), and creatinine levels on PoAF.

METHODS

The data of 81 patients who underwent off-pump coronary artery bypass graft (CABG) surgery was evaluated. Patients who developed atrial fibrillation (AF) in the first 48 hours post surgery constituted the PoAF (+) group, while those without AF constituted the PoAF (-) group. The pre-procedural hematological parameters of patients in both groups were included in the analysis.

RESULTS

The PoAF (+) group was comprised of 57 patients (70.3%) with a mean age of 65.5 ± 9.8 years, while the PoAF (-) group was comprised of 24 patients (29.7%) with a mean age of 60.6 ± 9.6 years. A comparison of the demographic characteristics of the two groups showed that age (P = .036), frequency of renal failure (P = .007), and frequency of DM (P = .001) were higher in the PoAF (+) group. An examination of the laboratory data revealed a negative correlation between Hct (P = .001) and albumin (P = .000) levels and presence of PoAF. Also, the MPV (P = .02), BUN (P = .007), and Cr (P = .043) values were higher in the PoAF (+) group.

CONCLUSION

The present study, whose focus was on the effects of albumin levels on the occurrence of PoAF, found that low levels of pre-procedural albumin, as one of the major proteins in the blood, is a risk factor for the development of PoAF.

摘要

背景

术后心房颤动(PoAF)是心脏直视手术后最常见的并发症之一。已有研究表明低白蛋白血症与一些心血管疾病有关。本研究评估了术前白蛋白、血尿素氮(BUN)和肌酐水平对 PoAF 的影响。

方法

评估了 81 例行非体外循环冠状动脉旁路移植术(CABG)的患者的数据。术后 48 小时内发生心房颤动(AF)的患者构成 PoAF(+)组,无 AF 的患者构成 PoAF(-)组。分析了两组患者术前的血液学参数。

结果

PoAF(+)组包括 57 例(70.3%)患者,平均年龄为 65.5±9.8 岁,PoAF(-)组包括 24 例(29.7%)患者,平均年龄为 60.6±9.6 岁。两组患者的人口统计学特征比较显示,PoAF(+)组年龄(P=0.036)、肾衰竭发生率(P=0.007)和糖尿病发生率(P=0.001)较高。实验室数据检查显示,Hct(P=0.001)和白蛋白(P=0.000)水平与 PoAF 的发生呈负相关。此外,PoAF(+)组的 MPV(P=0.02)、BUN(P=0.007)和 Cr(P=0.043)值较高。

结论

本研究重点关注术前白蛋白水平对 PoAF 发生的影响,发现术前白蛋白水平较低,作为血液中的主要蛋白质之一,是 PoAF 发展的危险因素。

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