老年冠心病病人发生心律失常的多因素Logistic回归分析

Multivariate Logistic Regression Analysis of Arrhythmia in Elderly Patients with Coronary Heart Disease

目的分析老年冠心病病人发生心律失常的危险因素。方法回顾性分析2015年11月—2016年10月在广西壮族自治区人民医院收治的436例老年冠心病病人,经24 h心电图、十二导联心电图等检查共87例病人被确定为心律失常。分析冠心病病人发生心律失常的性别、年龄、病程,是否进行过冠状动脉旁路移植术(CABG)或冠状动脉内支架植入术(PCI)、是否存在慢性阻塞性肺疾病、冠心病类型、是否存在糖尿病、是否存在高血压、是否存在心脏扩大、是否合并抑郁症、吸烟史,并对冠心病病人发生心律失常的多因素进行单因素和多因素Logistic回归分析。结果年龄>70岁、CABG治疗、合并慢性阻塞性肺疾病、心肌梗死、合并糖尿病、存在吸烟史的病人发生心律失常的人数,显著多于年龄≤70岁、PCI治疗、无慢性阻塞性肺疾病、心绞痛、无糖尿病、无吸烟史者,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,年龄、治疗方式、合并慢性阻塞性肺疾病、冠心病类型、合并糖尿病、存在吸烟史是老年冠心病病人发生心律失常的危险因素。结论年龄、治疗方式、合并慢性阻塞性肺疾病和糖尿病、冠心病类型、伴有吸烟史是冠心病病人发生心律失常的危险因素。

Objective To analyze the multiple factors of arrhythmia in elderly patients with coronary heart disease(CHD).Methods Retrospective analysis of 436 cases of elderly patients with CHD admitted in our hospital from september 2015 to october 2016,87 patients were identified as arrhythmia by 24 h electrocardiogram,12 lead electrocardiogram and other tests.Coronary-artery bypass grafting(CABG) or intracoronary stent implantation(PCI),the presence of chronic obstructive pulmonary disease,the type of coronary artery disease(CAD),and the severity of CAD,the presence of diabetes mellitus,whether depression,smoking history,and coronary heart disease in patients with arrhythmia by single factor and multivariate Logistic analysis.Results In patients with more than 70 years,the number of arrhythmias in patients with CABG,chronic obstructive pulmonary disease,angina pectoris,diabetes mellitus,hypertension,cardiomegaly,and smoking history was significantly higher than that of patients with less than 70 years,PCI,no chronic obstructive pulmonary disease,myocardial infarction,no diabetes,no smoking history,the difference was statistically significant(P <0.05).Conclusion Age,treatment modality,chronic obstructive pulmonary disease and diabetes mellitus,type of CHD,smoking history are risk factors of arrhythmia in patients with CHD.