心力衰竭合并复杂室性心律失常的相关因素分析  

Analysis on Related Factors of Heart Failure Complicated With Complex Ventricular Arrhythmia

作　　者：林志彬 张昊 甘道京 詹琼[1] 黄兴福[1] 李崇信[1] 曾庆春 LIN Zhibin;ZHANG Hao;GAN Daojing;ZHAN Qiong;HUANG Xingfu;LI Chongxin;ZENG Qingchun(Department of Cardiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院心血管内科,广州510515

出　　处：《中国循环杂志》2023年第10期1018-1023,共6页Chinese Circulation Journal

基　　金：国家自然科学基金(82070403);广州市科技计划项目(2023B01J1011)。

摘　　要：目的:探讨心力衰竭(心衰)患者合并复杂室性心律失常(CVA)的相关因素。法:本研究为回顾性横断面研究。纳入2019年1月至2022年8月在南方医科大学南方医院心血管内科住院的303例心衰患者。收集心衰患者的临床资料、实验室检查、彩色多普勒超声心动图以及24小时动态心电图检查结果。CVA包括频发室性早搏(24小时动态心电图监测中室性早搏比例>20%)、室性心动过速和心室颤动。根据24小时动态心电图检查结果将患者分为CVA组(n=167)和非CVA(NCVA)组(n=136)。采用单因素及多因素Logistic回归分析心衰患者合并CVA的相关因素。结果:单因素回归分析显示,左心室射血分数(LVEF)≤40%、左心室舒张末期内径(LVEDD)>55 mm、左心房内径(LAD)≥42 mm、心肌肌钙蛋白T(cTnT)>0.014 ng/ml、血K+≤3.5 mmol/L、男性、高血压、吸烟、饮酒和NYHA心功能分级Ⅳ级均与CVA风险增高相关(P均<0.05)。校正混杂因素后,多因素Logistic回归分析显示,LVEDD>55 mm(OR=3.000,95%CI:1.680~5.358)、cTnT>0.014 ng/ml(OR=2.112,95%CI:1.141~3.907)、血K+≤3.5 mmol/L(OR=3.645,95%CI:1.663~7.990)、高血压(OR=1.841,95%CI:1.103~3.073)、饮酒(OR=1.931,95%CI:1.056~3.530)均与CVA风险增高相关(P均<0.05)。结论:LVEDD增大、cTnT升高、血K+水平降低、高血压和饮酒均与心衰患者CVA风险增高相关。Objectives:To explore the related factors of heart failure(HF)complicated with complex ventricular arrhythmia(CVA).Methods:This is a retrospective cross-sectional study.This study selected 303 HF patients who met the inclusion criteria and were hospitalized in the cardiovascular department of Nanfang Hospital,Southern Medical University from January 2019 to August 2022.General clinical data,echocardiography and 24-hours Holter electrocardiogram results were analyzed.CVA includes frequent premature ventricular contraction(in 24-hour Holter monitor monitoring,the proportion of premature ventricular contraction>20%),ventricular tachycardia and ventricular fibrillation.According to the results of 24-hour Holter electrocardiogram,the patients were divided into two groups:non-CVA(NCVA)group(n=136)and CVA group(n=167).Univariate and multivariate logistic regression analysis were used to explore the related factors of HF patients combined with CVA.Results:Univariate regression analysis showed that Left ventricular Ejection fraction(LVEF),Left ventricular end diastolic diameter(LVEDD),left atrial diameter(LAD),cardiac troponin T(cTnT),serum K+,male,hypertension history,smoking history,alcohol consumption and NYHA IV were associated with an increased risk of CVA in HF patients(all P<0.05).Multivariate logistic regression analysis showed that LVEDD>55 mm(OR=3.000,95%CI:1.680-5.358),cTnT>0.014 ng/ml(OR=2.112,95%CI:1.141-3.907),serum K+≤3.5 mmol/L(OR=3.645,95%CI:1.663-7.990),hypertension(OR=1.841,95%CI:1.103-3.073),alcohol consumption(OR=1.931,95%CI:1.056-3.530)were independently associated with an increased risk of CVA in HF patients.Conclusions:Increased LVEDD,increased cTnT,lower serum K+,hypertension and alcohol consumption are associated with an increased risk of CVA in HF patients.

关 键 词：心力衰竭 复杂室性心律失常 相关因素 LOGISTIC回归 

分 类 号：R54[医药卫生—心血管疾病]