左心耳封堵术后房颤患者生活质量评价及其影响因素研究

摘要 目的：探讨左心耳封堵术（LAAC）术后对房颤（AF）患者的生活质量的影响，并分析其影响因素。方法：回顾性分析兰州大学第二医院2019年3月至2022年3月期间接受LAAC治疗的213例AF患者的临床资料。根据简明健康调查量表（SF-36）将213例LAAC术后AF患者分为低生活质量组（总分≤50分，n=107）和高生活质量组（总分＞50分，n=106）。收集并比较AF患者术前基线资料、实验室资料和影像学资料。采用多因素Logistic回归模型分析LAAC术后AF患者生活质量的影响因素。结果：低生活质量组心房颤动血栓发生危险度（CHA2DS2-VASc）评分高于高生活质量组（P<0.05）。低生活质量组的凝血酶原时间百分比高于高生活质量组（P<0.05）。高生活质量组红细胞水平高于低生活质量组（P<0.05）。高生活质量组的左心室射血分数（LVEF）高于低生活质量组（P<0.05）。多因素Logistic回归分析结果显示：CHA2DS2-VASc评分偏高、LVEF偏低是影响LAAC术后AF患者生活质量的危险因素（P<0.05）。结论：CHA2DS2-VASc评分偏高、LVEF偏低是影响LAAC术后AF患者生活质量的危险因素，可降低LAAC术后AF患者的生活质量。

Study on the Quality of Life Evaluation and its Influencing Factors in Patients with Atrial Fibrillation after Left Atrial Appendage Closure

ABSTRACT Objective: To explore the impact of quality of life in patients with atrial fibrillation (AF) after left atrial appendage closure (LAAC) and to analyze its influencing factors. Methods: The clinical data in 213 patients with AF who were received LAAC treatment in The Second Hospital of Lanzhou University from March 2019 to March 2022 were analyzed retrospectively. According to the score of the short form health survey scale (SF-36), 213 AF patients after LAAC were divided into low quality of life group (total scores less than or equal to 50 scores, n equal to 107) and high quality of life group (total scores less than or equal to 50 scores, n equal to 106). The baseline data, laboratory data, and imaging data in patients with AF before operation were collected and compared. The influencing factors of quality of life in patients with AF after LAAC was analyzed by multivariate Logistic regression model. Results: The AF recurrence risk (CHA2DS2-VASc) scores in low quality of life group was higher than that in high quality of life group (P<0.05). The percentage of prothrombin time in low quality of life group was higher than that in high quality of life group (P<0.05). The erythrocyte levels in high quality of life group was higher than that in low quality of life group (P<0.05). The left ventricular ejection fraction (LVEF) in high quality of life group was higher than that in low quality of life group (P<0.05). The results of multivariate Logistic regression analysis showed that high CHA2DS2-VASc scores and low LVEF were risk factors affected the quality of life in patients with AF after LAAC (P<0.05). Conclusion: High CHA2DS2-VASc scores and low LVEF are risk factors affecte the quality of life in patients with AF after LAAC, which can reduce the quality of life in patients with AF after LAAC.