摘要
目的探讨影响ST段抬高急性心肌梗死(STEMI)合并心律失常患者预后的独立危险因素。方法收集2008年6月至2014年6月在本院心内科就诊158例STEMI合并心律失常患者的临床资料,对影响其30 d病死率的基线资料及治疗因素分别进行应用单因素变量及Logistic回归分析。结果 158例STEMI合并心律失常患者30 d病死率为34.81%(55/158)。单因素分析显示性别、年龄、既往心肌梗死史、Killip分级、AMI部位、心率、入院时糖化血红蛋白水平等基线资料与STEMI合并心律失常患者30 d病死率有关(P<0.05)。溶栓治疗、肝素应用、阿司匹林、氯吡格雷、胰岛素、β-受体阻滞剂、ACEI、抗心律失常药物、降脂药物及钙离子拮抗剂的应用等治疗因素与STEMI合并心律失常患者30 d病死率有关(P<0.05)。经Logisitc多因素分析可知,年龄>60岁、前壁心肌梗死、Killip分级Ⅳ级、心率≥60次/min、入院糖化血红蛋白≥6.3、未应用ACEI、未进行降脂治疗是影响STEMI合并心律失常患者30 d病死率的独立危险因素。结论 STEMI并发致死性心律失常患者病死率高,患者基线资料及治疗因素均可影响患者预后。临床应对影响STEMI合并心律失常患者30 d病死率的独立危险因素进行干预,旨在改善患者近期预后。
Objective To investigate the effects of independent risk factors of patients with ST-segment elevation myocardial infarction（STEMI） concurrent into fatal arrhythmia.Methods The clinical data of 158 cases of STEMI concunent into fatal arrhythmia were collected from June 2008 to June 2014.The 30 d mortality baseline and treatment factors separately were applied with univariate and logistic regression analysis.Results The mortality rate of 30 d of 158 cases of arrhythmia in patients with STEMI were 34.81% （55/ 158）.The gender,age,previous history of myocardial infarction,Killip classification,AMI location,heart rate,admission baseline glycated hemoglobin level of arrhythmia were related with 30 d mortality of patients with STEMI concurrent into fatal arrhythmia（P 〈0.05）with univariate analysis.The thrombolytic therapy,heparin,aspirin,clopidogrel,insulin,β-blockers,ACEI,antiarrhythmic drugs,lipid-lowering dmgs,and calcium antagonist were related with 30 d mortality of patients with STEMI concurrent into fatal arrhythmia （P 〈 0.05） with univariate analysis.The age 〉 60 years,anterior myocardial infarction,Killip classification grade Ⅳ,heart rate ≥60 beats/min,admission glycosylated hemoglobin≥6.3,not applied of ACEI,not applied of lipid-lowering were the risk factor of 30 d mortality of patients with STEMI concurrent into fatal arrhythmia（P 〈0.05）.Conclusion The patients with STEMI concurrent into fatal arrhythmia are high mortality in patients with baseline data and treatment factors can affect patient prognosis.Clinical response to the independent risk factors for arrhythmia in patients with STEMI mortality 30 d intervention aimed at improving the prognosis in patients.
出处
《血栓与止血学》
2014年第6期296-300,共5页
Chinese Journal of Thrombosis and Hemostasis
关键词
ST段抬高急性心肌梗死
心律失常
危险因素
ST-segment elevation acute myocardial infarction
Arrhythmia
Risk factors
