冠心病急性左心衰竭患者入院24小时内新发室性心律失常的危险因素分析

Risk factors of new onset ventricular arrhythmia in acute left ventricular compensate heart failure patients within the first 24 hours after admission

目的分析冠心病急性左心衰竭（LVADHF）患者入院24h内发生室性心律失常的危险因素。方法回顾性分析2014年1月1日至2015年7月1日因冠心病急性左心衰竭入住北京世纪坛医院急诊病房且入院24h内进行持续心电监护的患者，收集这些患者的临床资料，对24h内发生室性心律失常的危险因素进行分析。结果研究共纳入患者121例，平均年龄（73．00±7．31）岁；发生室性心律失常患者78例，平均年龄（74．17±7．97）岁，其中男性65例（53．7％）。单因素分析结果提示，左室舒张末内径（LVEDD）增加、左室射血分数（LVEF）下降、高敏C反应蛋白（hs-CRP）升高、脑利钠肽前体（pro-BNP）升高及年龄增大是发生房性心律失常的危险因素。进一步的多因素Logsitic回归分析提示，LVEF低、高龄和pro-BNP升高是发生室性心律失常的独立危险因素。结论较低的LVEF、高龄和pro-BNP升高是冠心病左心衰竭患者入院24h内新发室性心律失常的独立危险因素。

Objective To investigate the risk factors of new on-set ventricular arrhythmia （VA） in left ventricular acute decompensate heart failure（LVADHF） patients admitted to emergency department（ED） in-patient ward within the first 24 hours after the admission. Methods LVADHF patients were retrospective enrolled from January 1st 201,4 to July 1st 2015 in the ED of our hospital. Relative clinical information was collected and analyzed to explore the risk factors which might affect the occurrence of new on-set VA. Results 121 patients were finally enrolled with average age of （73.00±7.31）years, and 78 patients（74.17±7.97）years were monitored VA oc- currence within the first 24 hours after admission. Univariate analysis revealed that larger left ventricle end-diastolic dimension（LVEDD）, decreased left ventricle ejection fraction（LVEF）, elevated pro-BNP, hs-CRP and age were associated with the increased risk of VA occurrence, further logistic analysis revealed that decreased LVEF and elevated age and pro-BNP were the independent risk factors affecting the VA occurrence. Conclusion Decreased LVEF, elevated age and pro-BNP were the independent risk factors affecting the VA occurrence within 24 hours after admission in LVADHF patients.