冠心病患者经皮冠状动脉介入术后发生恶性心律失常的影响因素  

Influencing factors of malignant arrhythmia after percutaneous coronary intervention in patients with coronary heart disease

作　　者：李晨 薛贤 张晓乐[1] Li Chen;Xue Xian;Zhang Xiaole

机构地区：[1]南阳市第二人民医院,473000

出　　处：《中国疗养医学》2021年第8期801-804,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的观察冠心病患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后恶性心律失常(malignant arrhythmia,MA)发生情况,并分析MA发生的影响因素。方法前瞻纳入2018年6月至2019年6月南阳市第二人民医院收治的93例拟接受PCI术治疗的冠心病患者,设计基线资料调查表在入院时详细询问并记录患者的一般资料,于PCI术后72 h内评估并统计患者MA发生情况,纳入全部可能因素,经单因素及多因素分析找出冠心病患者PCI术后MA发生的影响因素。结果93例冠心病患者PCI术后72 h内MA发生14例,发生率为15.05%(14/93);初步比较PCI术后发生与未发生MA的冠心病患者基线资料后,将比较差异有统计学意义的资料逐个纳入行单项回归分析,后将全部资料纳入并建立多元回归模型行多因素分析,结果显示,Killip分级高及超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、血糖、心肌肌钙蛋白-I(cTnI)、氨基末端脑钠尿肽原(NT-proBNP)过表达均是冠心病患者PCI术后MA发生的影响因素(OR>1,P<0.05)。结论冠心病患者PCI术后有较高的MA发生风险,可能与Killip分级高及hs-CRP、血糖、CK-MB、cTnI、NT-proBNP过表达有关,这类患者应引起重视。Objective To observe the incidence of malignant arrhythmia(MA)in patients with coronary heart disease after percutaneous coronary intervention(PCI),and to analyze the influencing factors of MA.Methods A total of 93 patients with coronary heart disease who were to receive PCI in the Second People's Hospital of Nanyang City from June 2018 to June 2019 were prospectively included.A baseline data questionnaire was designed to inquire and record the general information of the patients at admission.The incidence of MA in the patients was assessed and counted within 72 h after PCI,and all possible factors were included.Univariate and multivariate analyses were conducted to find out the influencing factors of MA occurrence in patients with coronary heart disease after PCI.Results The incidence of MA within 72 h after PCI was 15.05%(14/93)in 14 of 93 patients with coronary heart disease.After the preliminary comparison of the baseline data of CHD patients with and without MA after PCI,the data with statistically significant differences were included one by one for single-item regression analysis,and then all the data were included and a multivariate regression model was established for multivariate analysis.The results showed that,High Killip grade and the overexpression of hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),blood glucose,cardiac troponin-I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)were all influencing factors for the occurrence of MA after PCI in patients with coronary heart disease(OR>1,P<0.05).Conclusion Patients with coronary heart disease have a higher risk of MA after PCI,which may be related to high Killip grade and overexpression of hs-CRP,blood glucose,CK-MB,cTnI and NT-proBNP,and such patients should be paid attention to.

关 键 词：冠心病 经皮冠状动脉介入术 恶性心律失常 超敏C反应蛋白 肌酸激酶同工酶 血糖 心肌肌钙蛋白-I 氨基末端脑钠尿肽原 

分 类 号：R541.4[医药卫生—心血管疾病] R541.7[医药卫生—内科学]