摘要
目的研究行急诊经皮冠状动脉介入治疗术(PCI术)的急性ST段抬高心肌梗死患者新发房颤的预测因素。方法收集2015-02~2016-10间心内科住院的急性ST段抬高心肌梗死(STAMI)患者共620例,所有患者入院后均行急诊PCI术,观察随访1年,收集患者年龄、性别、既往史、血脂异常、心源性休克、心力衰竭、用药情况、犯罪血管、门球时间、超声心动图特征等资料。入组患者按照有无新发房颤(AF)分为AF组和非AF组,比较两组的临床基线资料、冠脉造影结果和超声心动图特征,利用直方图比较不同左房容积指数(LAVI)水平房颤发生率,多元Logistic回归分析急诊PCI术STAMI患者新发房颤的独立危险因素。结果 AF组和非AF组临床基线资料和冠脉造影结果方面相比较,平均年龄明显增高(P<0.05),女性、高血压病、心力衰竭、心源性休克、β-受体阻滞剂和抗心律失常药物使用比例明显增高(P<0.05),超声心动图特征方面二尖瓣E峰、LAVI、E/Em>15和LVEF<40%比例明显增高(P<0.05),LVEF明显降低(P<0.05)。多元Logistic回归分析提示心源性休克、LAVI、年龄为行急诊PCI术STAMI患者新发房颤的独立危险因素。不同LAVI水平患者相比较,随着LAVI增高,房颤发生率逐渐增高。结论心源性休克、LAVI、高龄是行急诊PCI术STAMI患者新发AF的独立预测因素。
Objective To explore the predictive factors of new-onset atrial fibrillation（AF） in patients with acute ST segment elevation myocardial infarction（ STAMI） undergoing emergency percutaneous coronary intervention（ PCI）. Methods A total of 620 hospitalized patients with STAMI in department of cardiology from February 2015 to October 2016 were collected. All patients underwent emergency PCI after admission and were followed up for one year. Clinical data of the patients were collected,including age,gender,previous history,dyslipidemia,cardiogenic shock,heart failure,drug application,criminal vascular,door to balloon time and echocardiographic characteristics. The patients were divided into AF group and non-AF group. Baseline clinical data,coronary angiographic findings and echocardiographic features were compared between the two groups. The incidence of atrial fibrillation in patients with different LAVI levels was compared by means of histogram. The independent risk factors of new onset AF in STAMI patients undergoing emergency PCI were analyzed by multivariate logistic regression. Results The average age in AF group was significantly higher than that in non-AF group（ P〈 0. 05）. The percentages of female,hypertension,heart failure,cardiogenic shock,beta blockers and antiarrhythmic drug use in AF group were significantly higher than those in non-AF group（ P〈 0. 05）. In echocardiographic features,the percentages of mitral E peak,LAVI,E/Em〉 15 and LVEF〈 40% increased in AF group（ P 〈0. 05）,while LVEF decreased（ P〈 0. 05）. Multiple logistic regression analysis showed that cardiogenic shock,LAVI and age were the independent risk factors of new-onset AF in STAMI patients undergoing emergency PCI. The incidence of atrial fibrillation increased gradually along with the growth of LAVI. Conclusion Cardiogenic shock,LAVI,and advanced age are the independent predictors of new-onset AF in STAMI patients undergoing emergency PCI.
出处
《山西医科大学学报》
CAS
2018年第2期136-139,共4页
Journal of Shanxi Medical University
关键词
急性ST段抬高心肌梗死
新发房颤
PCI术
心源性休克
左房容积指数
acute ST segment elevation myocardial infarction
new-onset atrial fibrillation
percutaneous coronary intervention surgery
cardiogenic shock
left atrial volume index
