心脏再同步治疗术后死亡患者危险因素分析  

Analysis of risk factors of death for patients undergoing cardiac resynchronization therapy

作　　者：温冬梅[1] 李晓宏[1] 蓝荣芳[1] 韩钟霖 徐伟[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心脏科,210008

出　　处：《中华心律失常学杂志》2016年第6期486-489,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的探讨影响心脏再同步治疗（CRT）患者术后心源性死亡的原因和危险因素。方法回顾性研究从2011年1月至2014年12月在南京鼓楼医院接受CRT植入的64例患者的临床资料。将接受CRT（P／D）植入术的患者分为术后死亡组、生存组行单因素及死亡组的多因素分析。结果①随访中位时间（21．5个月）后，研究对象总病死率为23．43％；②在单因素分析中，高龄、高血压、缺血性心肌病、心力衰竭（心衰）程度、合并症、术前左心室射血分数（LVEF）、心房颤动（房颤）、术前及术后QRS波、术后QTC间期等是术后心源性死亡的危险因素和预测因素。多因素分析中，高龄、术前心衰的严重程度、缺血性心肌病、肾功能不良是CRT心源性死亡的影响和预测因素。结论高龄、高血压、缺血性心肌病、心衰程度、合并症、术前LVEF值、房颤、术前及术后QRS波、术后QTC间期等可能是CRT术后心源性死亡的危险因素。Objective To investigate the causes and risk factors of postoperative death in patients with cardiac resynchronization therapy （CRT）. Methods A retrospective study from January 2011 to December 2014 in Nanjing Drum Tower Hospital for CRT（D） implanted in 64 patients.Will accept the CRT（D） implantation in patients.The patients with CRT（P/D）implantation were divided into the postoperative death group and survival group.The single factor and the multi factor analysis of the death group were performed. Results （1）After median follow-up （21.5 months ）, the total mortality rate was 23.43%. （2）In the single factor analysis, age, hypertension, the severity of ischemic cardiomyopathy, preoperative heart failure, severe complications, preoperative EF value, atrial fibrillation, preoperative and postoperative QRS wave and postoperative period between QTc is CRT the risk factors and predictors of death.Multivariate analysis ：the influence of CRT mortality and predictors of the severity of heart failure, ischemic cardiomyopathy, and renal function in the elderly. Conclusion Age, hypertension,the severity of ischemic cardiomyopathy, preoperative heart failure, severe complications, preoperative EF value, atrial fibrillation, preoperative and postoperative QRS wave and postoperative period between QTc is CRT the risk factors and predictors of death.

关 键 词：心脏再同步治疗 术后病死率 危险因素 

分 类 号：R541.6[医药卫生—心血管疾病]