Abstract: Objective　To compare the clinical features and prognostic differences of patients with atrial fibrillation and distinct troponin I level during emergency treatment,and to provide references for treatment of such patients.Methods　A total of 503 cases diagnosed with atrial fibrillation in the Central Hospital of Wuhan from 2008 to 2014 were selected as the subjects.Medical history,treatment history,laboratory examination,and clinical symptom of these patients were collected.Troponin I level of these patients during emergency treatment were measured.According to the troponin I level,all the patients were divided into two groups:the observation group（0.01-0.03 μg/L,220 cases） and the control group（<0.01 μg/L,283 cases）.In the follow-up for one year,survival information of the patients was gathered through return visits,telephone,E-mail,or examinations in community hospitals.Results　Differences of gender,atrial fibrillation history,hypertension,OSA detection rate,pacemaker implantation,ICD treatment ratio,Cr,and ventricular rate between the two groups were statistically significant（P<0.05）.Difference of incidence of dyspnea,chest pains,and vertigo between the two groups were not statistically significant（P>0.05）;the incidences of palpitation and fatigue of the observation group were higher than those of the control group（P<0.05）.During the follow-up,five（1.8%） cases in the control group and four（1.8%） cases in the observation group were lost.The total mortality and MI-related mortality of the observation group were higher than those of the control group（P<0.05）.Conclusion　The patients with atrial fibrillation and slightly elevated troponin I level mostly have atrial fibrillation history;the MI-related mortality and total mortality of these patients increase within one year.

Key words: Atrial fibrillation, Troponin I, Myocardial infarction, Prognosis

摘要： 目的　通过比较急诊入院时不同肌钙蛋白I（TnI）水平心房颤动患者的临床特征及预后的差异，为心房颤动的治疗提供参考。方法　选取2008—2014年于武汉中心医院诊断为心房颤动的患者503例为研究对象。收集患者既往病史、既往治疗史、实验室检查及临床症状资料，并于急诊入院时检测TnI水平。根据TnI水平将患者分为观察组（0.01～0.03 μg/L，220例）和对照组（<0.01 μg/L，283例）。以本次心房颤动的诊断时间为起点，以复诊、电话、邮件或社区医院检查等方式进行随访，观察1年内患者生存情况。结果　两组性别，心房颤动病史、高血压、阻塞性睡眠呼吸暂停综合征（OSA）检出率，起搏器植入术、埋藏式复律除颤器（ICD）治疗比例，肌酐（Cr）水平、心室率比较，差异均有统计学意义（P<0.05）。两组呼吸困难、胸痛、头晕发生率比较，差异均无统计学意义（P>0.05）。观察组患者心悸、乏力发生率高于对照组（P<0.05）。随访期间，对照组失访5例（1.8%）,观察组失访4例（1.8%）。观察组全因病死率及心肌梗死（MI）病死率高于对照组（P<0.05）。结论　TnI水平轻度升高的心房颤动患者多合并心房颤动病史，且1年内发生MI致死及总病死率增高。

关键词: 心房颤动, 肌钙蛋白I, 心肌梗死, 预后