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|本期目录/Table of Contents|

不同类型冠心病患者心律失常的相关因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第4期
页码:
443-446
栏目:
临床研究
出版日期:
2016-04-01

文章信息/Info

Title:
Clinically relevant factors of arrhythmia in patients with different types of coronary heart disease
作者:
张子新; 洪 茜; 余陆娇; 谭 玲
(中国医科大学附属第一医院心血管内科，辽宁 沈阳 110001)
Author(s):
ZHANG ZI-xin;  HONG Qian;  YU Lu-jiao;  TAN Ling
(1.Department of Cardiovascology, First Hospital, China Medical University, Shenyang 110001, Liaoning, China)
关键词:
急性冠脉综合征; 慢性缺血综合征; 心律失常; 相关因素
Keywords:
acute coronary syndrome;  chronic ischemic syndrome;  arrhythmia;  risk factors
分类号:
R514.4；R541.7
DOI:
-
文献标识码:
A
摘要:
目的 探讨不同类型冠心病患者心律失常发生情况的临床相关因素。方法 1 014例冠心病患者，分为急性冠脉综合征(ACS)和慢性缺血综合征(CIS)两种类型，采用动态心电图检查记录所发生的心律失常类型，分析比较各组中房性心律失常或室性心律失常的发生与年龄、性别、高血压病、糖尿病、高脂血症、冠脉病变支数、血钾、脑尿钠肽(BNP)、左室射血分数(LVEF)和左室舒张末期内径(LVEDD)值的相关性，并通过logistic回归分析，找出心律失常发生情况的相关因素。结果 ①ACS患者的年龄、性别、高血压、糖尿病、高脂血症、冠脉病变支数、BNP、LVEF及LVEDD值在发生房性或室性心律失常中的差异无统计学意义，而血钾值在发生房性或室性心律失常中的差异有统计学意义(P<0.05)；logistic回归分析显示，ACS患者发生室性心律失常的独立相关因素是低血钾(P=0.027，OR：2.009，95%CI：1.084-3.726)。②CIS患者的年龄、性别、高血压病、糖尿病、高脂血症、冠脉病变支数、血钾值在发生房性或室性心律失常中的差异无统计学意义，而BNP、LVEF及LVEDD值在发生房性或室性心律失常中的差异有统计学意义（P<0.05）；logistic回归分析显示，CIS患者发生室性心律失常的独立相关因素是LVEF降低(P=0.048，OR：3.561，95%CI：1.010-12.553)。结论 低血钾可能是ACS组患者发生室性心律失常的独立相关因素;而LVEF降低可能是CIS组患者发生室性心律失常的独立相关因素。
Abstract:
AIM To investigate the relationship between arrhythmia and clinically relevant factors in patients with different types of coronary heart disease (CHD). METHODSA total of 1014 CHD patients were enrolled and divided into acute coronary syndrome (ACS) group and chronic ischemic syndrome (CIS) group. HOLTER was used to record the types of arrhythmia. Relation of occurrence of atrial arrhythmia or ventricular arrhythmia in both groups and number of coronary artery lesions, serum potassium, BNP, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were analyzed. Risk factors of arrhythmia were examined by logistic regression analysis. RESULTSIn ACS group, no significant differences were observed in the number of coronary artery lesions, BNP, LVEF and LVEDD between atrial arrhythmia or ventricular arrhythmia, but there was a significant difference in the serum potassium value between atrial arrhythmia or ventricular arrhythmia occurring in the group (P<0.05). Logistic regression analysis revealed that hypokalemia (P=0.027, OR: 2.009, 95% CI: 1.084-3.726) was an independent risk factor for ventricular arrhythmia occurring in the group. In CIS group, no significant differences were found in the number of coronary artery lesions and serum potassium value between atrial arrhythmia or ventricular arrhythmia, but there were significant differences in BNP, LVEF and LVDD between atrial arrhythmia or ventricular arrhythmia (P<0.05). Logistic regression analysis revealed that lower LVEF (P=0.048, OR: 3.561, 95%CI: 1.01-12.553) was an independent risk factor of ventricular arrhythmia occurring in this group. CONCLUSIONVentricular arrhythmia is more likely to occur in ACS patients with hypokalemia and in CIS patients with higher BNP and LVDD and lower LVEF. Hypokalemia may be a risk factor of ventricular arrhythmia for ACS patients, and lower LVEF may be a risk factor for ventricular arrhythmia for CIS patients.

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备注/Memo

备注/Memo:
收稿日期：2015-09-05.
基金项目：辽宁省社会发展攻关计划项目资助（20122250019）
作者简介：张子新，副教授，博士 Email：1871521270@qq.com
更新日期/Last Update: 2016-04-01