高敏C反应蛋白对急性心肌梗死患者并发恶性室性心律失常的预测价值  

The predictive value of high sensitivity C-reactive protein in patients with acute myocardial infarction complicated with malignant ventricular arrhythmia

作　　者：史云桃[1] 蒋廷波[2] 

机构地区：[1]高淳人民医院,高淳211300 [2]苏州大学附属第一医院

出　　处：《内科急危重症杂志》2015年第3期199-201,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨急性心肌梗死(AMI)患者住院期间合并恶性心律失常的相关危险因素。方法:收集2012年因临床特征及冠脉造影诊断AMI的325例患者的临床资料,并将患者分为恶性室性心律失常组(A组)48例,非恶性室性心律失常组(B组)277例,应用多因素logistic逐步回归分析AMI患者发生恶性心律失常的危险因素。结果:与B组比较,A组年龄偏大,空腹血糖、尿酸、血肌酐、甘油三酯、高敏C反应蛋白(hs-CRP)水平、ST段抬高型心肌梗死、右冠状动脉病变比例均明显升高(P<0.05);收缩压、舒张压、血红蛋白、白蛋白、肌酐清除率、左室射血分数(LVEF)值明显下降(P<0.05)。多因素logistic回归分析显示右冠状动脉病变、hs-CRP水平升高是AMI患者合并恶性心律失常的危险因素(P<0.01)。结论:AMI发生恶性心律失常比例较高,且受多种因素影响。其中右冠状动脉(RCA)病变、hs-CRP水平升高可能是AMI发生恶性心律失常的独立危险因素,具有预测价值。Objective： To investigate the related risk factors of the occurrence of malignant ventricular arrhythmia（ MVA） in in-patients with acute myocardial infarction（ AMI）. Methods： Clinical data of 325 AMI patients by clinical manifestations and coronary angiography were collected. The patients were divided into to MVA group（ group A,48 cases） and non-MVA group（ group B,277 cases）. Multiple logistic regression analysis were performed to detect the possible factors of MVA. Results： Compared with those of group B,patients in group A were elder,and serumLevels of fasting blood glucose,uric acid,serum creatinine,triglycerides,high sensitivity C-reactive protein（ hs-CRP）,ST elevation myocardial infarction（ STEMI）,the lesion of right coronary artery（ RCA） were significantly increased（ P〈0. 05）. Systolic blood pressure,diastolic blood pressure,hemoglobin,albumin,glomerular filtration rate and left ventricular ejection fraction（ LVEF） were significantly decreased（ P〈0. 05）. Multiple logistic regression analyses found that the lesion of RCA and increased level of hsCRP were independent risk factors of MVA（ P〈0. 01）. Conclusions： The incidence of MVA in patients with AMI was high which was impacted with various factors. Among the factors,the lesion of RCA and increased level of hs-CRP are independent risk factors for MVA in patients with AMI.

关 键 词：急性心肌梗死 危险因素 恶性室性心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]