STEMI患者急诊PCI术后出现频发室性早搏的危险因素研究  

Study on risk factors for frequent ventricular premature beats in STEMI patients after emergency PCI

作　　者：李光智[1] 林称心 LI Guangzhi;LIN Chenxin(Ward Ⅰ,Department of Cardiovascular Medicine,Hainan Traditional Chinese Medicine Hospital,Hainan,Haikou 570203,China)

机构地区：[1]海南省中医院心血管内科一病区,海南海口570203

出　　处：《中国医药科学》2024年第8期139-142,163,共5页China Medicine And Pharmacy

基　　金：海南省卫生健康行业科研项目(21A200393)。

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠脉介入术(PCI)后出现频发室性早搏(简称“室早”)的危险因素。方法选择2021年7月至2023年7月在海南省中医院胸痛中心就诊的108例STEMI患者纳入本研究,所有患者按急诊PCI术后1周内是否出现频发室早进行分组,分为频发室早组(n=25)和非频发室早组(n=83)。然后记录所有患者入院时的基线数据、急诊PCI资料以及PCI术后血清8-羟基脱氧鸟苷(8-OHDG)水平,对其进行统计学分析。结果基线数据方面,两组患者年龄、性别、烟酒嗜好史、生命体征、Killip分级、电解质水平和左心室射血分数方面比较,差异无统计学意义(P>0.05)。频发室早组患者合并糖尿病的患者数量显著高于非频发室早组,差异有统计学意义(P<0.05);两组患者STEMI发病至到达医院大门时间、医院大门至导丝通过时间、肌钙蛋白I、脑钠肽、肌红蛋白、肌酸激酶同工酶、是否为三只血管病变和是否为左主干或前降支近端病变方面比较,差异无统计学意义(P>0.05)。此外,频发室早组PCI术后血清8-OHDG水平也显著高于非频发室早组,差异有统计学意义(P<0.05)。二元logistic回归分析显示,糖尿病病史和PCI术后高水平的8-OHDG是STEMI患者急诊PCI术后出现频发室早的危险因素(P<0.05)。结论糖尿病病史和PCI术后高水平的8-OHDG是STEMI患者急诊PCI术后出现频发室早的危险因素。Objective To explore the risk factors of frequent ventricular premature beats(VPBs)after emergency percutaneous coronary intervention(PCI)in patients with ST-elevated myocardial infarction(STEMI).Methods A total of 108 STEMI patients who visited the Chest Pain Center of Hainan Hospital of Traditional Chinese Medicine from July 2021 to July 2023 were selected and included in this study.All patients were divided into two groups based on whether they had frequent ventricular premature beats within one week after emergency PCI,namely the frequent ventricular premature beat group(n=25)and the nonfrequent ventricular premature beat group(n=83).Then,baseline data,emergency PCI data,and serum 8-hydroxy-deoxyguanosine(8-OHDG)levels after PCI of all patients at admission were recorded for statistical analysis.Results In terms of baseline data,there was no statistically significant difference between the two groups of patients in terms of age,gender,history of smoking and drinking habits,vital signs,Killip grade,electrolyte levels,and left ventricular ejection fraction(P>0.05).The number of patients with diabetes mellitus in the frequent ventricular premature beat group was significantly higher than that in the nonfrequent ventricular premature beat group,with statistically significant difference(P<0.05).There was no statistically significant difference between the two groups of patients in the time from the onset of STEMI to the arrival of the hospital gate,the time from the hospital gate to the passage of the guide wire,troponin I,brain natriuretic peptide,myoglobin,creatine kinase isoenzyme,whether it was a three vessel lesion,and whether it was a proximal lesion of the left main or anterior descending branch(P>0.05).In addition,the serum 8-OHDG levels in the frequent ventricular premature beat group after PCI were significantly higher than those in the nonfrequent ventricular premature beat group,with statistically significant difference(P<0.05).Bivariate logistic regression analysis showed that the history of diabetes

关 键 词：急性ST段抬高型心肌梗死 经皮冠脉介入术 频发室早 8-羟基脱氧鸟苷 

分 类 号：R541.7[医药卫生—心血管疾病]