冠心病放置支架后监护期发生心律失常的危险因素分析  

Risk factor analysis of arrhythmia with coronary heart disease during guardianship period after placing the stent

作　　者：刘芳[1] 张永全[1] 王丽萍[1] LIU Fang ZHANG Yongquan WANG Liping(Department of Cardiovascular Medicine, Xinhua Hospital Affiliated to Dalian University, Liaoning Province, Dalian 116021, China)

机构地区：[1]大连大学附属新华医院心血管内科,辽宁大连116021

出　　处：《中国医药导报》2017年第17期42-45,共4页China Medical Herald

摘　　要：目的分析冠心病放置支架后监护期发生心律失常的危险因素。方法回顾性分析大连大学附属新华医院2013年1月~2015年6月收治的264例因冠心病需放置支架的患者资料。将所有患者根据不同临床因素进行分类,先用单因素分析法分析不同条件下患者发生心律失常的比例差异,再进行多因素Logistic回归分析,得出冠心病患者放置支架后在监护期发生心律失常的危险因素。结果 264例冠心病放置支架患者中有73例在监护期发生心律失常,比例为27.65%。经χ2检验显示,年龄<65岁、术前心功能分级为Ⅰ~Ⅱ级、术前左室射血分数(LVEF)<50%、无高血压、无高血脂、无糖尿病、无慢性阻塞性肺疾病(COPD)、无吸烟史、放置支架数量为1个以及术中不进行体外循环的条件下发生心律失常的比例低于同因素对立条件下发生心律失常的比例(P<0.05)。多因素Logistic回归分析结果,年龄、术前心功能分级、LVEF、高血脂、COPD、支架数量是冠心病放置支架患者在监护期发生心律失常的独立危险因素(P<0.05)。结论年龄、术前心功能分级、术前LVEF、高血脂、COPD、支架数量均会影响冠心病患者在置入支架术后发生心律失常的概率。Objective To analyze the risk factor of arrhythmia with coronary heart disease during guardianship period after placing the stent.Methods Clinical data of 264 patients with placing the stent due to coronary heart disease in Xinhua Hospital Affiliated to Dalian University from January 2013 to June 2015 were analyzed retrospectively.They were classified by different factors to analyze the difference by chi-square test.The factors were analyzed with Logistic regression analysis to get the risk factors that effect arrhythmia to patients with coronary heart disease during guardianship period after placing the stent.Results 73 cases among 264 patients happened arrhythmia during guardianship period after placing the stent and the rate was 27.65%.The result showed arrhythmia ratio in patients with less than 65 years old, preoperative cardiac function grade Ⅰ-Ⅱ, preoperative LVEF was less than 50%, no hypertension, no hyperlipidemia, no diabetes, no COPD, no smoking history, number of stents was one and no cardiopulmonary bypass in the surgery were lower than the ratio of contradictory factors, and the differences all were statistically significant（P 〈0.05）.Then the multivariate Logistic regression analysis showed that age, preoperative cardiac function grade, LVEF, high blood lipids, COPD and number of stents were independent risk factors of arrhythmia to patients with coronary heart disease during guardianship period after placing the stent（P〈 0.05）.Conclusion The arrhythmia rate of patients with different age, preoperative cardiac function grade, LVEF, high blood lipids, COPD and number of stents will have differences.

关 键 词：冠心病 支架置入 监护期 心律失常 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]