急性ST段抬高型心肌梗死患者合并恶性室性心律失常情况调查及其影响因素分析  

Investigation of Malignant Ventricular Arrhythmia in Patients with Acute ST-Segment Elevation Myocardial Infarction and Analysis of Its Influencing Factors

作　　者：姜楠 JIANG Nan(Department of Cardiology,Dong'e County People's Hospital of Liaocheng City,Liaocheng 252000,China)

机构地区：[1]聊城市东阿县人民医院心内科,山东聊城252000

出　　处：《反射疗法与康复医学》2024年第24期121-123,127,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者合并恶性室性心律失常(MVA)情况及其影响因素分析。方法选取2022年5月—2024年5月聊城市东阿县人民医院收治的84例STEMI患者为研究对象,依据住院期间是否合并MVA将其分为MVA组与非MVA组,收集比较两组患者的年龄、性别、吸烟史、饮酒史、合并高血压、合并糖尿病、Killip分级、合并低钾血症、梗死部位、病变类型等多方面的基础资料,开展Logistic回归分析,获得影响并发MVA的独立危险因素。结果84例STEMI患者中,并发MVA有28例,MVA发生率为33.33%(28/84);单因素分析显示,两组年龄、Killip分级、合并低钾血症、病变类型比较,组间差异有统计学意义(P<0.05);Logistic回归分析显示,年龄≥65岁(OR=9.167,95%CI=3.135~26.800)、Killip分级Ⅲ~Ⅳ级(OR=6.158,95%CI=1.315~28.830)、合并低钾血症(OR=3.800,95%CI=1.450~9.956)、多支病变(OR=4.500,95%CI=1.680~12.055)为影响STEMI患者并发MVA的独立危险因素(P<0.05且OR>1)。结论STEMI患者合并MVA受年龄≥65岁、Killip分级Ⅲ~Ⅳ级、合并低钾血症、多支病变影响较大,需高度重视,尽早识别高风险群体,完善治疗方案。Objective To investigate the incidence and risk factors of malignant ventricular arrhythmia(MVA)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 84 STEMI patients admitted to Donge County People's Hospital of Liaocheng from May 2022 to May 2024 were selected as the research objects,according to whether MVA occurred during hospitalization,they were divided into MVA group and non-MVA group.The basic data of age,gender,smoking history,drinking history,hypertension,diabetes mellitus,Killip classification,hypokalemia,infarction location and lesion type were collected and compared between the two groups.Logistic regression analysis was performed to obtain the independent risk factors affecting MVA.Results Among 84 patients with STEMI,28 cases were complicated with MVA,and the incidence of MVA was 33.33%(28/84);univariate analysis showed that age,Killip classification,combined hypokalemia and lesion type were compared between the two groups,and the differences between the two groups were statistically significant(P<0.05);Logistic regression analysis showed that age≥65 years(OR=9.167,95%CI=3.135~26.800),Killip classificationⅢ~Ⅳ(OR=6.158,95%CI=1.315~28.830),combined with hypokalemia(OR=3.800,95%CI=1.450~9.956)and multivessel disease(OR=4.500,95%CI=1.680~12.055)were independent risk factors for MVA in STEMI patients(P<0.05 and OR>1).Conclusion STEMI patients with MVA are significantly affected by age≥65 years,Killip classificationⅢ~Ⅳ,hypokalemia,and multivessel disease.High risk groups should be identified as early as possible,and the treatment plan should be improved.

关 键 词：急性ST段抬高型心肌梗死 恶性室性心律失常 影响因素 

分 类 号：R542.22[医药卫生—心血管疾病]