中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (06): 447-451,457.doi: 10.3969/j.issn.1671-4091.2026.06.002

• 临床研究 • 上一篇    下一篇

心房颤动对血液透析患者预后影响的初步探讨

黄 静    于 玲    李艳春    孙倩美   

  1. 孙倩美 100020 北京，1首都医科大学附属北京朝阳医院肾内科
  • 收稿日期:2025-09-30 修回日期:2026-03-28 出版日期:2026-06-12 发布日期:2026-06-12
  • 通讯作者: 孙倩美 E-mail:sunqianmei5825@163.com

Preliminary discussion on the clinical significance of atrial fibrillation on the prognosis of hemodialysis patients

HUANG Jing, YU Ling, LI Yan-chun, SUN Qian-mei   

  1. sunqianmei5825@163.com
  • Received:2025-09-30 Revised:2026-03-28 Online:2026-06-12 Published:2026-06-12
  • Contact: 100020 北京，1首都医科大学附属北京朝阳医院肾内科 E-mail:sunqianmei5825@163.com

摘要： 目的 探讨心房颤动对血液透析患者死亡的影响。 方法 收集2019年9月—2022年8月在北京朝阳医院肾内科透析室行血液透析的患者为研究对象，根据是否存在心房颤动将患者分为2组，随访至2024年9月，记录治疗及并发症情况、转归情况，采用Kaplan-Meier生存曲线及landmard分析组间生存率，采用COX回归分析心房颤动对患者预后的影响。 结果 本研究共纳入172例患者，其中心房颤动组37例(21.5%)，中位随访时间61(32，61)月。心房颤动组患者心脑血管并发症比例高于非心房颤动组(78.4%比51.9%，χ2=8.365，P=0.005)。随访期间共死亡46例，36个月内心房颤动组与非心房颤动组间全因死亡率及心血管死亡率比较差异无统计学意义(χ2 =1.436，P=0.231；χ2 =0.580，P=0.446)，36个月后心房颤动组全因死亡率、心血管死亡率高于非心房颤动组患者(χ2 =5.908，P=0.015；χ2 =3.951，P=0.047)。单因素COX回归分析提示心房颤动是血液透析患者全因死亡(HR=2.984，95%CI：1.178～7.562，P=0.021)和心血管死亡(HR=3.127，95%CI：1.954～10.249，P=0.041)的影响因素。 结论 血液透析患者心房颤动患病率高，临床应给予重视，需进一步行相关研究为血液透析患者心房颤动的治疗指南提供临床依据。

关键词: 心房颤动, 血液透析, 死亡率

Abstract: Objective  To explore the effect of atrial fibrillation (AF) on the mortality of hemodialysis (HD) patients.  Methods  HD patients in the Nephrology Department of Beijing Chaoyang Hospital from September 2019 to August 2022 were collected. According to the presence of AF, they were divided into the AF group and non-AF group, and followed up to September 2024 to record the treatment, complications and outcome. Kaplan-Meier survival curve and landmark analysis were used to analyze the survival rate between different groups. Cox regression was used to analyze the effect of AF on the prognosis of HD patients.  Results  A total of 172 patients were included, 37 patients (21.5%) were in the AF group, and the median follow-up time was 61 (32, 61) months. The proportion of cardiovascular and cerebrovascular complications in the AF group was significantly higher than that in the non-AF group (78.4% vs. 51.9%，χ2=8.365，P=0.005). During the follow-up period, 46 cases died, and there were no significant differences in all-cause and cardiovascular mortality between the AF group and non-AF group between 0 to 36 months (χ2=1.436, P=0.231; χ2=0.580, P=0.446), but all-cause and cardiovascular mortality were significantly higher in AF group than those in non-AF group after 36 months (χ2=5.908, P=0.015; χ2=3.951, P=0.047). Univariate COX regression analysis suggested that AF was an influencing factor for all-cause mortality (HR=2.984, 95%CI: 1.178～7.562, P=0.021) and cardiovascular mortality (HR=3.127, 95%CI: 1.954～10.249, P=0.041) in HD patients.  Conclusions  In this preliminary study, the incidence of AF in HD patients is high, and therefore attention should be paid to it in clinical practice. Further studies are needed to provide clinical basis for the treatment guidelines of AF in HD patients.

Key words: Atrial fibrillation, Hemodialysis, Mortality

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