老年ST段抬高型心肌梗死后发生恶性室性心律失常的危险因素分析

Analysis of the Risk Factors of MVA after STEMI in Elderly Patients

目的:探讨老年ST段抬高型心肌梗死患者发生恶性室性心律失常的相关危险因素。方法:对150例老年ST段抬高型心肌梗死患者的临床资料进行回顾性分析,根据有无恶性室性心律失常(MVA)将其分为对照组(非MVA)和观察组(MVA),对两组的临床资料及指标进行比较,并进行Logistic回归分析。结果:性别、年龄、吸烟史、高血压史、糖尿病史、心绞痛史、血糖、糖化血红蛋白(Hb A1c)、血钾、肌酐(Cr)、BUN、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及病变类型与老年ST段抬高型心肌梗死患者发生MVA的发生无关,Killip分级、Cr和LDL与MVA的发生有关,且Killip分级和Cr水平是发生MVA的独立危险因素。结论:Killip分级和Cr水平是诱发老年ST段抬高型心肌梗死后MVA的独立危险因素。

Objective： To investigate the risk factors of malignant ventricular arrhythmias in elderly patients with ST segment ele- vation myocardial infarction （STEMI）. Methods： 150 elderly patients with acute STEMI were analyzed retrospectively. Based on the presence or absence of malignant ventricular arrhythmia （MVA）, the patients were divided into the control group （non-MVA） and obser- vation group （MVA）, the clinical data and indicators were compared between two groups. Results： Gender, age, smoking history, history of hypertension, diabetes mellitus, history of angina, blood glucose, glycosylated hemoglobin （HbA 1 c）, serum potassium, creatinine （Cr）, BUN, triglyceride （TG）, total cholesterol （TC）, high-density lipoprotein （HDL）, low density lipoprotein （LDL） and lesion type of MVA had no relationship with the occurrence of MVA in elderly patients with STEMI, while Killip classification, Cr, and LDL were correlated with the occurrence of MVA, and Killip class, creatinine levels were independent risk factors for the occurrence of MVA. Conclusion： Killip classification and Cr levels were independent risk factors of the occurrence of MVA in elderly patients with STEMI.