急性心肌梗死合并新发心房颤动患者住院期间临床特点及预后分析  

Investigation of the clinical characteristics and prognosis about acute myocardial infarction with new onset atrial fibrillation

作　　者：韩萍[1] 宋丽萍[1] 杨静文[1] 郭云飞[1] 张福春[1] Han Ping;Song Liping;Yang Jingwen;Guo Yunfei;Zhang Fuchun.(Department of Cardiology, Haidian Hospital, Beijing 100080, China)

机构地区：[1]北京市海淀医院心内科,100080

出　　处：《北京医学》2018年第3期197-200,共4页Beijing Medical Journal

摘　　要：目的探讨急性心肌梗死合并新发心房颤动(新发房颤)患者的临床特点和预后。方法选取2014年1月至2017年1月北京市海淀医院收治的急性心肌梗死住院患者368例,分为研究组(合并新发房颤,82例)和对照组(无新发房颤,286例),收集患者基本情况、冠心病危险因素、心脏彩超等资料,分析2组患者的临床特点、心脏彩超结果及预后情况。结果 2组的年龄、术前心功能Killip分级>1、再灌注时间>6 h、前壁心肌梗死、二尖瓣反流及糖尿病发生率比较,差异有统计学意义(P<0.05)。2组吸烟、高血压和脑梗死发生率比较,差异无统计学意义(P>0.05)。研究组左房内径、左室舒张末径及左室收缩末径高于对照组,射血分数低于对照组,差异均有统计学意义(P<0.05)。2组室间隔厚度、左室后壁厚度差异无统计学意义(P>0.05)。研究组病死率及心力衰竭发生率与对照组比较,均显著较高,差异有统计学意义(P<0.05)。结论临床应对急性心肌梗死合并新发房颤患者的各项危险因素进行有针对性的预防,加强新发房颤监测,改善患者预后。Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction with new onset atrial fibrillation. Methods A total of 368 cases of hospitalized patients from January 2014 to January 2017 was selected and divided into study group （patients with new onset atrial fibrillation, 82 cases） and control group （no new onset atrial fibrillation, 286 cases） in Beijing Haidian Hospital. The basic information, risk factors of coronary heart disease and echocardiography of patients were collected and the clinical characteristics, eehoeardiography and prognosis of the two groups were analyzed. Results There were significant differences in age, preoperative cardiac function, Killip classification 〉 1, reperfusion time 〉 6 h, anterior myocardial infarction, mitral regurgitation and diabetes mellitus between the study group and the control group （P 〈 0.05）. There was no significant difference between the two groups in smoking, hypertension and cerebral infarction （P 〉 0.05）. The left atrial diameter, left ventrieular end diastolic diameter and left ventricular end systolic diameter of the study group were higher than those of the control group, and the ejection fraction was lower than that of the control group. There was no significant difference between the two groups in the thickness of the interventricular septum and the thickness of the left posterior wall （P 〉 0.05）. The rate of mortality and incidence of heart failure in study group were higher than those of the control group （P 〈 0.05）. Conclusion The clinical risk factors of the prognosis of patients with acute myocardial infarction and new onset atrial fibrillation could be targeted to prevent and detect the new atrial fibrillation to improve the prognosis of patients.

关 键 词：急性心肌梗死 新发房颤 临床特点 预后 

分 类 号：R541.75[医药卫生—心血管疾病]