某医院2013-2016年老年急性心肌梗死患者严重心律失常发生情况及影响因素分析  

Occurrence and Influencing Factors of Severe Arrhythmia in Elderly Patients with Acute Myocardial Infarction between 2013 and 2016

作　　者：刘继红[1] 王桂[2] 李慧颖[3] 冯双[4] 

机构地区：[1]山东省医学科学院附属医院心血管内科,济南250031 [2]济南市长清区人民医院心血管内科 [3]山东省医学科学院附属医院特检科 [4]淄博市临淄区人民医院口腔科

出　　处：《解放军预防医学杂志》2017年第10期1203-1205,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：基金项目:山东省医学科学院医药卫生科技创新工程

摘　　要：目的探讨老年急性心肌梗死患者严重心律失常发生情况及影响因素。方法收集本院2013-2016年收治的182例老年急性心肌梗死患者的临床资料及随访资料,根据是否发生心律失常分为心律失常组和对照组,分析老年急性心肌梗死患者严重心律失常发生情况,采用Logistic回归分析模型探讨影响老年急性心肌梗死患者严重心律失常发生的影响因素。结果 182例急性心肌梗死患者中97例严重心律失常(53.30%);通过分析老年急性心肌梗死患者病理比较结果显示:严重心律失常患者病程短,心率变异性时域指数水平和频域指数降低,白细胞计数和中性粒细胞计数水平较高,心电图QTV指数变异水平降低,发生在前壁梗死较多见,而且患者以左冠状动脉闭塞多见(P<0.05);经Logistic回归模型分析结果显示:病程短、心率变异性时域指数水平和频域指数降低、前壁梗死、左冠状动脉闭塞、QTV水平降低是影响老年急性心肌梗死患者严重心律失常发生的相关危险因素(P<0.001)。结论老年急性心肌梗死患者严重心律失常发生率较高,应积极采取有效预防和可控措施,从而降低老年急性心肌梗死病死率。Objective To investigate the occurrence and influencing factors of severe arrhythmia in elderly patients with a- cute myocardial infarction. Methods The clinical data and follow-up data of 182 elderly patients with acute myocardial infarction were collected from 2013 to 2016. The patients were divided into arrhythmia and control groups according to the occurrence of ar-rhythmia＊ The incidence of severe arrhythmia in elderly patients with acute myocardial infarction was analyzed. Logistic regression analysis was used to investigate the infLuencing factors of severe arrhythmia in elderly patients with acute myocardial infarction. Results A total of 97 patients （5 3 .3 0% ） were diagnosed with arrhythmia among the 182 patients with acute myocardial infarc-tion. The results of pathologic comparison in elderly patients with acute myocardial infarction showed that among patients with se-vere arrhythmia, thecourse of disease was shor t（P〈0.05） ,heart rate variability time domain index levels and domain indexes de- creased （P〈0. 05） , white blood cell count and neutrophil count were high （P〈0. 05） , the QTV index of ECG decreased （P〈0.05） , anterior wall infarction occurred （P〈0.05） ,and left coronary artery occlusion was more common （P〈0.05）. The re- sults of Logistic regression analysis suggested a short course of disease,a decrease of heart rate variability, time domain indexes and frequency domain indexes,anterior wall infarction,and left coronary artery occlusion. Decreased QTV levels were risk factorsfor severe arrhythmia in elderly patients with acute myocardial infarction （P〈0. 001） . Conclusion The incidence of severe ar-rhythmia in elderly patients with acute myocardial infarction is relatively high. Effective measures of prevention and control should be taken to reduce the mortality in elderly patients with acute myocardial infarction.

关 键 词：老年 急性心肌梗死 心律失常 影响因素 

分 类 号：R542.22[医药卫生—心血管疾病]