急性冠脉综合症患者心源性猝死的相关因素分析

Related factors analysis of sudden cardiac death in patients with acute coronary syndrome

目的探讨急性冠脉综合症患者心源性猝死的相关因素，为预防-tD源性猝死及提高抢救成功率提供参考依据。方法选择2012年5月～2013年5月解放军72433部队门诊部ACS并发SCD患者100例为研究组及同期住院的非SCD患者100例为对照组。对研究对象行一般资料统计，统计其危险因素分布，针对有统计学意义的相关因素，再采用Logistic回归方法行多因素回归分析。结果两组研究对象的危险因素分布结果显示，左室射血分数（EF）〈30．00％、脑钠肽（BNP）〉30000U／L、持续性高血压、持续性心律失常、情绪刺激、过度劳累在两组中分布比较．差异有统计学意义（P〈0．05）。观察组患者相关因素多因素逐步回归分析结果显示，在其他条件等同的情况下，低EF值、持续性心律失常、持续性高血压、过度劳累、情绪刺激等对患者有影响（均P〈0．05），尤其是低EF值（OR=9．07,P〈0．01）、持续性心律失常（OR=6．12，P〈0．01）对患者的影响更为显著。结论针对相关危险因素，早期预防至关重要，应给予及时、有效的相应的护理干预，降低死亡率。

Objective To study the related factors of sudden cardiac death in patients with acute coronary syndrome, and to provide reference for the prevention of sudden cardiac death and improving the success rate of rescue. Methods 100 cases of acute coronary syndrome with sudden cardiac death from May 2012 to May 2013 in Department of Outpa- tient, the 72433 Troops of Chinese People＇s Liberation Army were selected as observation group; 100 cases without the SCD in the same period were chosen as control group. General statistics were done for the study objects, the distribu- tion of risk factors were counted, then Logistic regression method was used on the multi-factor stepwise regression anal- ysis in view of the related factors with statistically significant. Results The results for risk factors for distribution in two groups of research objects were showed that, the differences of distribution in the two groups including EF values 〈 30.00%, BNP 〉 30 000 U/L, durative arrhythmia, persistent hypertension, emotional stimuli, overwork were statistically sig- nificant （P 〈 0.05）. The results of associated factors multi-factor stepwise regression analysis in observation group showed that, in the case of other conditions with equal, low EF value, durative arrhythmia, persistent hypertension, overwork, emotional stimuli were the influence factors （all P 〈 0.05）, especially the low EF value （OR = 9.07, P 〈 0.01）, and the durative arrhythmia （OR = 6.12, P 〈 0.01）. Conclusion In view of the related risk factors, early preven- tion is important, and it is right to give timely and effective corresponding nursing intervention to reduce mortality.