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急性心肌梗死患者恶性室性心律失常的发生率及其危险因素分析

杨培根   

  1. 天津市胸科医院心内七科
  • 收稿日期:2011-10-21 修回日期:2011-11-14 出版日期:2012-09-15 发布日期:2012-09-15
  • 通讯作者: 杨培根

The Incidence and Risk Factors of Malignant Ventricular Arrhythmia in Patients with Acute Myocardial Infarction

  • Received:2011-10-21 Revised:2011-11-14 Published:2012-09-15 Online:2012-09-15

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摘要： 目的：探讨急性心肌梗死患者恶性室性心律失常（MAV）的发生率及相关危险因素。方法：回顾性分析我院2007年1月～2011年6月急性心肌梗死患者650例，根据动态心电图结果将其分为MAV组和非MAV组，然后计算MAV的发生率并对MAV与年龄、性别、吸烟史、高血压、糖尿病、高脂血症、心肌梗死病史、肌酸激酶，肌酸激酶同工酶，肌钙蛋白I,白细胞计数，中性粒细胞计数，血小板计数，血红蛋白，甘油三脂,总胆固醇，低密度脂蛋白，高密度脂蛋白，血钾，低血钾，血尿素氮，血肌酐，血糖，入院心功能Killip分级，心电图校正的T波峰末间期，心率变异性，直接PCI术开通梗死相关血管及恢复期超声结果等参数进行单因素相关分析和 Logistic回归分析。结果：650例急性心肌梗死患者中共有216例发生MAV（33.2%）。Logistic回归分析显示：肌酸激酶、肌钙蛋白I、低血钾、心功能Killip分级、校正的T波峰末间期、心率变异性、未行直接PCI术开通梗死相关血管是MAV的危险因素。结论：MAV在急性心肌梗死患者中发病率较高并且是急性心肌梗死患者主要死亡病因之一，对具备以上MAV相关危险因素的患者应引起足够的临床重视。

关键词: 急性心肌梗死, 室性心律失常, 发生率, 危险因素

Abstract: Objective:To explore the incidence and risk factors of malignant ventricular arrhythmia in patients with acute myocardial infarction. Methods:A retrospective study was performed on 650 patients with acute myocardial infarction from January 2007 to June 2011. According to the Holter outcomes，the patients with acute myocardial infarction were divided into malignant ventricular arrhythmia(MVA) group and non-MAV group.Then incidence rate of MVA were measured and age, gender, history of smoking, hypertension, diabetes, hyperlipidemia, history of old myocardial infarction, creatine kinase, creatine kinase MB, Troponin I, white blood cell count, neutrophil count ,platelet count, hemoglobin, triglycerides, total cholesterol, low density lipoprotein, high density lipoprotein, potassium, low blood potassium, blood urea nitrogen, serum creatinine, blood glucose, Killip class, corrected Tpeak-Tend interval, heart rate variability, opening of infarct-related artery by direct PCI, ultrasound results of convalescence were recorded and determined by univariate correlation analysis and Logistic regression analysis．Results: Among the 650 patients, MAV occurred in 216 patients and the incidence of MAV was 33.2%. Logistic regression analysis showed that creatine kinase, Troponin I, low blood potassium, Killip class, corrected Tpeak-Tend interval, heart rate variability,not opening of infarct-related artery by direct PCI were risk factors of MAV.Conclusion: The incidence of malignant ventricular arrhythmia in patients with acute myocardial infarction was higher and was a major cause of death, Adequate clinical attention should be paid to patients who have the above risk factors of MAV.

Key words: acute myocardial infarction, ventricular arrhythmia, incidence rate, risk factors