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作 者:高莹[1] 张小丽[1] 王莉[1] 邢凤梅[1] 钟雪莲[1] 吴晓璐[1]
机构地区:[1]河北联合大学护理与康复学院,河北唐山063000
出 处:《现代预防医学》2013年第23期4445-4448,共4页Modern Preventive Medicine
基 金:河北省人事厅课题[(2008)199]
摘 要:目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者再灌注心律失常(reperfusion arrhythmias,RA)的发生情况及其影响因素。方法回顾性分析两所三甲医院5年内的急性心肌梗死行静脉溶栓或急诊PCI治疗后发生再灌注心律失常患者的临床资料,并通过单因素和多因素分析探讨RA发生的相关因素。结果 331例患者中RA的发生率为58.31%。年龄﹤45岁、血压﹤90/60 mm Hg、血糖﹥6 mmol/L的患者RA的发生率较高;梗死前无心绞痛、下壁梗死、发病至血管再通时间﹤6 h的患者RA的发生率较高;患者手术时间﹥1 h、动脉压力波形异常、病变血管血流TIMI 0级、多支血管病变RA的发生率较高(P均﹤0.05)。多因素Logistic回归分析显示:梗死前心绞痛是RA发生的保护因子,动脉压力波形异常、病变血管血流TIMI 0级、发病至血管再通时间≤6 h是RA发生的危险因素。结论再灌注心律失常的发生与选择静脉溶栓或PCI治疗方式无关,梗死前心绞痛是急性心肌梗死RA发生的保护因子,动脉压力波形异常、病变血管血流TIMI 0级、发病至血管再通时间≤6 h是RA发生的危险因素。OBJECTIVE To explore the occurrence of reperfusion arrhythmias (RA) and its influencing factors among the acute myocardial infarction (AMI) patients. METHODS Collected the clinical data in the last five years in two hospitals, those clinical data might be from acute myocardial infarction (AMI) patients with going on intravenous thrombolysis or percu- taneous coronary intervention (PCI), and then having reperfusion arrhythmias. Explored RA related factors by univariate and multivariate analysis. RESULTS In this study, the incidence rate of RA was 58.31%. The influencing factors of RA was: age 〈 45 years, high blood pressure 〈 90/60mmHg, blood glucose 〉 6mmol/L, no angina before infarction, inferior wall infarc- tion, onset to recanalization 〈 6h, mean operative time 〉 lh, arterial pressure waveform abnormalities, blood flow to the coronary arteries TIMI 0 and muhi-vessel disease (P 〈 0.05). Muhivariate Logistic regression analysis showed that infarction angina was the protection factor to RA, and arterial pressure waveform abnormalities, blood flow to the coronary arteries TIMI 0 level, onset to recanalization time 〈 6h were the risk factors to RA. CONCLUSION The occurrence of reperfusion arrhyth- mias (RA) has no relationship with selecting intravenous thrombolysis or PCI treatment. Infarction angina is the protection factor to RA, and arterial pressure waveform abnormalities, blood flow to the coronary arteries TIMI 0 level, onset to re- canalization time 〈 6h are the risk factors to RA.
分 类 号:R542.22[医药卫生—心血管疾病]
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