文章摘要
徐辽杭,程震锋,李国洪,彭继仁,金美娟.急性心肌梗死患者经冠脉介入术后恶性心律失常的危险因素分析[J].中国临床保健杂志,2018,21(2):199-202.
急性心肌梗死患者经冠脉介入术后恶性心律失常的危险因素分析
The risk factor analysis of malignant arrhythmia after coronary intervention in patients with acute myocardial infarction
投稿时间:2017-12-11  
DOI:10.3969/J.issn.1672-6790.2018.02.016
中文关键词: 心肌梗死  血管成形术,气囊,冠状动脉  心律失常,心性  危险因素
英文关键词: Myocardial infarction  Angioplasty,balloon,coronary  Arrhythmias,cardiac  Risk factors
基金项目:
作者单位E-mail
徐辽杭 浙江东阳市人民医院心内科,322100 wans_2001@163.com 
程震锋 浙江湖州市中心医院心内科  
李国洪 浙江东阳市人民医院心内科,322100  
彭继仁 浙江东阳市人民医院心内科,322100  
金美娟 浙江东阳市人民医院心内科,322100  
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中文摘要:
      目的 探讨急诊经皮冠状动脉介入治疗(PCI)治疗后的急性心肌梗死(AMI)患者恶性心律失常(MA)相关的危险因素。方法 选取经心电图检查确诊行PCI的AMI患者184例。根据患者术后72 h内有无MA分为MA组(n=51)和非MA组(n=133)。观察AMI所累及的室壁、心功能Killip分级、AMI发病后至再通时间等基线资料和血肌酐、糖化血红蛋白、低密度脂蛋白-胆固醇水平、血钾、血糖、C反应蛋白、肌钙蛋白等各类生化指标。结果 MA组患者的心肌梗死区域所累及的室壁、心功能Killip分级、AMI发病后至再通时间、血肌酐、糖化血红蛋白、低密度脂蛋白、血钾、血糖、C 反应蛋白、肌钙蛋白较非MA组均差异有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,AMI发病后至再通时间于6 h之内(OR=2.239)、心肌梗死区域所累及的前壁(OR=2.675)、心功能KillipⅣ级(OR=7.127)、血肌酐高(OR=4.103)、糖化血红蛋白高(OR=4.212)、血钾低(OR=4.673)、血糖高(OR=2.104)、C 反应蛋白高(OR=2.167)和肌钙蛋白高(OR=1.817)均是AMI患者并发MA的危险因素(P<0.05)。结论 AMI患者并发MA受心肌梗死区域所累及的室壁、心功能Killip分级、AMI发病后至再通时间、血肌酐、糖化血红蛋白、低密度脂蛋白、血钾、血糖、C 反应蛋白以及肌钙蛋白多因素影响,应尽可能针对各种危险因素采取针对性的措施干预患者病情,减少MA的发生。
英文摘要:
      Objective To analyze the baseline data and biochemical indicators of patients with acute myocardial infarction after coronary intervention and to explore the risk factors associated with malignant arrhythmias.Methods A total of 184 cases of AMI patients treated with PCI were examined by ECG in the cardiac department of the people′s hospital of DongYang City,Zhejiang Province.MA group (n=51) and non-ma group(n=133) were divided according to 72 hours after surgery.We observed the AMI patients with acute myocardial infarction areas involving Killip classification,room wall,and cardiac function after AMI onset to baseline data,such as the recanalization time and serum creatinine,glycosylated hemoglobin,low density lipoprotein cholesterol levels,potassium,glucose,c-reactive protein,troponin and other kinds of biochemical index.Results Acute myocardial infarction areas involving,and cardiac function,the recanalization after AMI onset time,creatinine,glycosylated hemoglobin,low density lipoprotein cholesterol levels,potassium,glucose,c-reactive protein,troponin of MA group were different from non MA group statistically (P<0.05).Multiariable logistic regression analysis results showed that after the onset of AMI and recanalization time within 6 hours (OR=2.239),the involvement of the anterior wall myocardial infarction areas KillipⅣ (OR=2.675),and cardiac function (OR=7.127),serum creatinine level is high(OR=4.103),high glycosylated hemoglobin (OR=4.212),low potassium (OR=4.673),high blood sugar (OR=2.104),high (OR=2.167) and c-reactive protein troponin high (OR=1.817) were the risk factors of AMI patients complicated with MA(P<0.05).Conclusion Patients with acute myocardial infarction complicated with malignant arrhythmia in myocardial infarction area are affected by the room wall,cardiac function,Killip classification,recanalization after AMI onset time,creatinine,glycosylated hemoglobin,low density lipoprotein cholesterol levels,potassium,glucose,c-reactive protein and troponin factors,we should take corresponding measures as far as possible according to various risk factors to reduce the occurrence of malignant arrhythmia.
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