急性心肌梗死并发严重心律失常的影响因素分析

Analysis of the Impact Factors of Serious Arrhythmia in Acute Myocardial Infarction

目的:探讨急性心肌梗死并发严重心律失常的影响因素,为其临床防治提供参考依据。方法:选择2011年3月～2012年7月发生AMI24小时以内就诊并住院的63名患者为研究对象,按照是否发生严重心律失常分为A组(发生严重心律失常组)和B组(未发生心律失常组)两组,分别记录和分析患者的性别、年龄、发病时间、既往病史、不良习惯,以及入院时心肌酶、血常规检查及心电图检查结果。结果:A组患者的白细胞总数及中性粒细胞数均显著多于B组,但发病时间明显短于B组,差异有统计学意义(P<0.005),而两组的中性粒细胞比率、CK、CK-MB值、性别、年龄、心电图是否出现Q波、既往病史及不良习惯比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果表明仅发病时间、中性粒细胞计数与急性心肌梗死患者并发严重心律失常有明显的相关性(P均<0.05)。结论:发病时间、中性粒细胞计数>7×109/L是急性心肌梗死患者并发严重心律失常的危险因素。

Objective：This study was designed to investigate clinical data of patients with acute myocardial infarction（AMI）occurring severe arrhythmia and to probe its related factors.Methods：Based on whether they had serious arrhythmia in AMI,63 eligible patients were divided into two groups.The clinical data including gender,age,onset time,pre-existing conditions,bad habits,the blood routine test,cardiac enzymes and electrocardiogram were collected and the relationship of clinical data between serious arrhythmia was analyzed.Results：Compared with group B,patients in group A with serious arrhythmias had a siginificantly higher baseline WBC count（P0.01） and neutrophil（P0.01）.The onset time in group A is shorter than B（P0.05）.There was no significant difference between two groups in gender,age,onset time,pre-existing conditions,bad habits and other collected data.In multivariate logistic regression analysis,serious arrhythmias in AMI related with onset time（P0.05）,elevated neutrophil（P0.05）.Conclusion：The onset time,neutrophils count 7×109/L were the risk factors for AMI patients cpmbined with serious arrhythmia.