STEMI患者恶性室性心律失常与血脂、血糖、同型半胱氨酸代谢的关系  

Relationship between malignant ventricular arrhythmia and blood lipid,blood glucose and homocysteine metabolism in patients with STEMI

作　　者：赵婕[1] 王芳[1] 郭静[1] 楚英杰[2] ZHAO Jie;WANG Fang;GUO Jing;CHU Yingjie(Cardiovascular Internal Medicine Department,the 7th People's Hospital of Zhengzhou,Zhengzhou 450000;Cardiovascular Internal Medicine Department,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州市第七人民医院心血管内科,河南郑州450000 [2]河南省人民医院心血管内科,河南郑州450003

出　　处：《临床医学研究与实践》2022年第3期11-13,共3页Clinical Research and Practice

基　　金：河南省医学科技攻关计划项目(No.2017T02052)。

摘　　要：目的探讨ST段抬高型心肌梗死(STEMI)患者恶性室性心律失常与血脂、血糖、同型半胱氨酸(Hcy)代谢的关系。方法选择2016年3月至2020年10月在心血管内科接受急诊经皮冠状动脉介入治疗(PCI)的142例STEMI患者作为研究对象,根据PCI后48 h内是否发生恶性室性心律失常将其分为A组(34例,发生恶性室性心律失常)和B组(108例,未发生恶性室性心律失常)。比较两组的一般临床信息、心电图信息、实验室指标,总结STEMI患者发生恶性室性心律失常的影响因素。结果两组的性别、年龄、高血压病史、高脂血症病史、吸烟史、饮酒史、BMI、Killip心功能分级、碎裂QRS波、病理性Q波比较,差异无统计学意义(P>0.05);A组前侧壁心肌梗死患者占比高于B组,差异具有统计学意义(P<0.05)。A组的血红蛋白、血钾水平明显低于B组,低密度脂蛋白胆固醇、血糖、血Hcy水平明显高于B组,差异具有统计学意义(P<0.05);两组的甘油三酯、高密度脂蛋白胆固醇、血尿酸、肌酐、尿素、谷丙转氨酶、谷草转氨酶、血钠水平比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,脂代谢异常、应激性高血糖、高Hcy血症是STEMI患者发生恶性室性心律失常的危险因素(P<0.05)。结论STEMI患者恶性室性心律失常与脂代谢异常、应激性高血糖、高Hcy血症有关。Objective To investigate the relationship between malignant ventricular arrhythmia and blood lipid,blood glucose and homocysteine(Hcy)metabolism in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 142 patients with STEMI underwent emergency percutaneous coronary intervention(PCI)in the cardiovascular internal medicine department from March 2016 to October 2020 were selected and divided into group A(34 cases,malignant ventricular arrhythmia)and group B(108 cases,no malignant ventricular arrhythmia)according to whether malignant ventricular arrhythmia occurred within 48 h after PCI.The general clinical information,ECG information and laboratory indexes of the two groups were compared,and the influencing factors of malignant ventricular arrhythmia in patients with STEMI were summarized.Results There were no significant differences in the gender,age,history of hypertension,history of hyperlipidemia,history of smoking,history of drinking,BMI,Killip cardiac function grade,fragmented QRS wave and pathological Q wave between two groups(P>0.05).The proportion of patients with anterior wall myocardial infarction in the group A was higher than that in the group B,and the difference was statistically significant(P<0.05).The levels of hemoglobin and blood potassium in the group A were significantly lower than those in the group B,while the levels of low density lipoprotein cholesterol,blood glucose and blood Hcy were significantly higher than those in the group B,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of triglyceride,high density lipoprotein cholesterol,blood uric acid,creatinine,urea,alanine aminotransferase,aspartate aminotransferase and blood sodium between the two groups(P>0.05).The multivariate Logistic regression analysis showed that abnormal lipid metabolism,stress hyperglycemia and hyperhcy were the risk factors of malignant ventricular arrhythmia occurred in patients with STEMI(P<0.05).Conclusion Malignant ventri

关 键 词：ST段抬高型心肌梗死 恶性室性心律失常 血脂 血糖 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]