2019年青海地区冠心病合并心律失常患者心率控制及影响因素

Heart rate control and influencing factors of patients with coronary heart disease and arrhythmia in Qinghai in 2019

目的了解2019年青海地区冠心病合并心律失常患者心率控制情况,分析心率控制影响因素。方法回顾性分析2019年医院收治的263例冠心病合并心律失常患者资料。根据出院后6个月静息心率控制情况将患者分为心率控制良好组(n=151)和心率控制不良组(n=112)。比较不同心率控制患者临床特征,分析心率控制影响因素。结果2019年青海地区冠心病合并心律失常患者房性心律失常发生率(55.51%)较高,心率失常类型以房性早搏为主;出院后6个月心率控制良好率为57.41%;心率控制与出院时静息心率、年龄、吸烟情况、治疗方式、冠心病类型、心绞痛CCS分级、NYHA分级、高血压、糖尿病、心脏扩大、β受体阻滞剂使用、心率控制目标知晓情况有关(t=32.370,P<0.001;χ2=26.300,P<0.001;χ2=45.690,P<0.001;χ2=15.161,P<0.001;χ2=67.500,P<0.001;χ2=18.788,P<0.001;χ2=10.228,P=0.006;χ2=78.769,P<0.001;χ2=66.374,P<0.001;χ2=51.165,P<0.001;χ2=43.360,P<0.001;χ2=40.315,P<0.001),差异有统计学意义;仍在吸烟、冠状动脉旁路移植术、心肌梗死、合并糖尿病、未服用β受体阻滞剂和心率控制知晓差为冠心病合并心律失常患者心率控制不良独立危险因素(P<0.05)。结论2019年青海地区冠心病合并心律失常患者心率控制良好率处于中上水平,应加强对高危人群心率控制相关知识的健康宣教。

Objective To investigate the heart rate control and related influencing factors of patients with coronary heart disease and arrhythmia in Qinghai in 2019.Methods Clinical data of 263 patients with coronary heart disease and arrhythmia in our hospital in 2019 were retrospectively analyzed.According to their resting heart rate control status at 6 months after discharge,the patients were divided into a well-controlled heart rate group(n=151)and a poorly controlled heart rate group(n=112).The clinical characteristics of patients with different heart rate control status were compared,and influencing factors of heart rate control were analyzed.Results Among patients with coronary heart disease and arrhythmia in Qinghai in 2019,atrial arrhythmia had a higher incidence rate(55.51%),and the main types of arrhythmia were atrial premature beat.The rate of good heart rate control of patients at 6 months after discharge was 57.41%.The heart rate control status was related to the resting heart rate at discharge,age,smoking status,treatment methods,type of coronary heart disease,CCS grade,NYHA classification,hypertension,diabetes mellitus,cardiac enlargement,use of beta blocker and awareness of heart rate control target at discharge(t=32.370,P<0.001;χ2=26.300,P<0.001;χ2=45.690,P<0.001;χ2=15.161,P<0.001;χ2=67.500,P<0.001;χ2=18.788,P<0.001;χ2=10.228,P=0.006;χ2=78.769,P<0.001;χ2=66.374,P<0.001;χ2=51.165,P<0.001;χ2=43.360,P<0.001;χ2=40.315,P<0.001),and the difference was statistically significant.Smoking,coronary artery bypass grafting,myocardial infarction,diabetes mellitus,non-use of beta blockers,and poor awareness of heart rate control were independent risk factors for poor heart rate control in patients with coronary heart disease and arrhythmia(P<0.05).Conclusion In 2019,the rate of good heart rate control in patients with coronary heart disease and arrhythmia in Qinghai is above the average level,and the health education on heart rate control relate knowledge for high-risk groups should be strengthened.