| 史云桃,蒋廷波.急性ST段抬高型心肌梗死患者恶性室性心律失常的危险因素研究[J].安徽医药,2018,22(11):2134-2136. |
| 急性ST段抬高型心肌梗死患者恶性室性心律失常的危险因素研究 |
| Risk factors of malignant ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction |
| 投稿时间：2017-04-23 |
| DOI： |
| 中文关键词: 急性ST段抬高型心肌梗死 危险因素 恶性室性心律失常 |
| 英文关键词: ST-segment elevation myocardial infarction Risk factor Malignant ventricular arrhythmia |
| 基金项目:“十三五南京市卫生青年人才培养工程”项目(QKX17211) 急性ST段抬高型心肌梗死患者恶性室性心律失常的危险因素研究史云桃1,蒋廷波2(1.南京高淳人民医院心内科,江苏 南京 211300；2.苏州大学附属第一医院心内科,江苏 苏州 215000) |
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| 中文摘要: |
| 目的探讨急性ST段抬高型心肌梗死(STEMI)患者住院期间并发恶性心律失常(MVA)的相关危险因素。方法 收集苏州大学附属第一医院2011年11月至2012年6月205例因临床特征及冠状动脉造影诊断STEMI的患者临床资料,分为恶性室性心律失常组(A组)38例,非恶性室性心律失常组(B组)167例,采用多因素logistic逐步回归分析STEMI患者发生恶性心律失常的危险因素。结果(1)两组相比,年龄[(70.08±10.19)岁vs.(61.09±14.79)岁],女性比例(28.9% vs.13.2%),白蛋白[(37.36±4.61)×109 L-1 vs.(39.49±4.29)×109 L-1]、肌酐清除率[(66.26±28.96)mL·min·1.73m-2vs.(91.52±26.79)mL·min·1.73m-2)、纤维蛋白原[(3.81±1.03)g·L-1vs.(3.47±0.82)g·L-1]、尿酸[(384.07±137.00)μmol·L-1vs.(337.24±111.43)μmol·L-1]、血肌酐(98.5 μmol·L-1vs.78.0 μmol·L-1)、三酰甘油(1.0 mmol·L-1vs.1.31 mmol·L-1)、高敏C-反应蛋白(hs-CRP)(13.57 g·L-1vs.6.29 g·L-1)、心功能凯氏分级3～4级(18.4% vs.6.6%)、心肌梗死溶栓治疗血流分级0～1(89.5% vs.74.1%)、病变支数[三支(23.7% vs.11.7%)]、右冠状动脉病变(RCA)(27.9% vs.29.9%)、血压[(113.39±23.66)/(68.18±14.21)mmHg vs.(124.92±18.83)/(75.66±12.25)mmHg]、血红蛋白[(121.97±15.78)g·L-1vs.(131.37±18.75)g·L-1)等指标比较均差异有统计学意义(P<0.05)。(2)多因素logistic回归分析显示罪犯血管(右冠状动脉)、hs-CRP是STEMI患者合并恶性心律失常的危险因素(OR=2.314、1.152,P＜0.05)。结论STEMI发生恶性心律失常比例较高,RCA、hs-CRP可能是STEMI发生MVA的独立危险因素。 |
| 英文摘要: |
| Objective To discuss the risk factors of malignant ventricular arrhythmia (MVA) in patients with ST-segment elevation myocardial infarction (STEMI).Methods Related data and coronary angiograms (CAG) of 205 patients with STEMI were collected in The First Affiliated Hospital of Suzhou University from November 2011 to June 2012.The patients were assigned into malignant ventricular arrhythmia group (group A,38 cases) and non-malignant ventricular arrhythmia group (group B,167 cases).Multiple logistic regression analysis was performed to analyze the risk factors of MVA in patients with STEMI.Results (1) By comparison of two groups,the differences in age [(70.08±10.19) vs.(61.09±14.79)],female (28.9% vs.13.2%),albumin [(37.36±4.61)×109 L-1 vs.(39.49±4.29)×109 L-1],creatinine clearance rate [(66.26±28.96) mL·min·1.73m-2 vs.(91.52±26.79)mL·min·1.73m-2],fibrinogen [(3.81±1.03) g·L-1 vs.(3.47±0.82) g·L-1],uric acid [(384.07±137.00) μmol·L-1 vs.(337.24±111.43) μmol·L-1],serum creatinine (98.5 μmol·L-1 vs.78.0 μmol·L-1),triglycerides (1.0 mmol·L-1 vs.1.31 mmol·L-1),high sensitivity C-reactive protein (hs-CRP) (13.57 g·L-1 vs.6.29 g·L-1),Killip class Ⅲ～Ⅳ (18.4% vs.6.6%),thrombolysis and thrombin inhibition in myocardial infarction (TIMI) flow grades 0 to 1 (89.5% vs.74.1%),number of stenosed coronary vessel (23.7% vs.11.7%),the right coronary artery (RCA) (27.9% vs.29.9%),blood pressure [(113.39±23.66)/(68.18±14.21) mmHg vs.(124.92±18.83)/(75.66±12.25) mmHg] and hemoglobin [(121.97±15.78)g·L-1vs.(131.37±18.75) g·L-1] were statistically significant (P<0.05).(2) Multivariable logistic regression analysis indicated that vessel of the culprit (right coronary artery) and hs-CRP were independent risk factors of MVA in STEMI patients (OR=2.314,1.152,P＜0.05).Conclusion The possibility of STEMI patients with MVA is high.The level of high sensitivity C-reactive protein and the lesion of RCA are independent risk factors for MVA in patients with STEMI. |
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