严重心律失常患者永久心脏起搏器植入术后三尖瓣反流的影响因素分析

Analysis on the influencing factors of tricuspid regurgitation after permanent cardiac pacemaker implantation in patients with severe arrhythmia

目的探讨严重心律失常患者永久心脏起搏器植入术后三尖瓣反流的影响因素。方法选取2019年3月至2020年3月我院收治的93例植入永久心脏起搏器的严重心律失常患者作为研究对象,根据患者术后三尖瓣反流程度将其分为无反流组和反流组。统计所有患者临床资料,并经Logistic回归分析寻找严重心律失常患者植入永久心脏起搏器术后发生三尖瓣反流的影响因素。结果93例严重心律失常患者行永久心脏起搏器植入术后,有70例患者术后未发生三尖瓣反流,占75.27%,有23例患者术后发生三尖瓣反流,占24.73%。经单因素分析显示,严重心律失常患者永久心脏起搏器植入术后发生三尖瓣反流不受年龄、性别、右心室电极导线内径、高血压、糖尿病的影响(P>0.05),可能受起搏器植入时间、合并心房颤动、术前1级三尖瓣反流等因素影响(P<0.05);经Logistic回归分析显示,起搏器植入时间≥5年、合并心房颤动、术前1级三尖瓣反流均为严重心律失常患者植入永久心脏起搏器术后出现三尖瓣反流的影响因素(OR>1,P<0.05)。结论起搏器植入时间≥5年、合并心房颤动、术前1级三尖瓣反流均为严重心律失常患者永久心脏起搏器植入术后三尖瓣反流的主要影响因素,故临床可根据其影响因素进行合理干预,以降低三尖瓣反流发生率,促进预后。

Objective To investigate the influencing factors of tricuspid regurgitation after permanent cardiac pacemaker implantation in patients with severe arrhythmia.Methods A total of 93 patients with severe arrhythmia implanted with permanent cardiac pacemakers who were admitted to our hospital from March 2019 to March 2020 were selected as the study subjects.According to the degree of postoperative tricuspid regurgitation,patients were divided into non-regurgitation group and regurgitation group.The clinical data of all patients were statistically analyzed.Logistic regression analysis was used to find out the influencing factors of tricuspid regurgitation after permanent cardiac pacemaker implantation in patients with severe arrhythmia.Results After 93 patients with severe arrhythmia underwent permanent pacemaker implantation,70 patients did not experience tricuspid regurgitation after the operation,accounting for 75.27%.Tricuspid regurgitation occurred in 23 patients,accounting for 24.73%.Univariate analysis showed that tricuspid regurgitation after permanent cardiac pacemaker implantation in patients with severe arrhythmia was not affected by age,gender,diameter of right ventricular electrode lead,hypertension,and diabetes(P>0.05),but might be affected by pacemaker implantation time,complicated atrial fibrillation,preoperative grade 1 tricuspid regurgitation and other factors(P<0.05);Logistic regression analysis showed that the pacemaker implantation time≥5 years,complicated atrial fibrillation,and preoperative grade 1 tricuspid regurgitation were all influencing factors of tricuspid regurgitation after permanent pacemaker implantation in patients with severe arrhythmia(OR>1,P<0.05).Conclusion Pacemaker implantation time≥5 years,complicated atrial fibrillation,and preoperative grade 1 tricuspid regurgitation are the main influencing factors for tricuspid regurgitation after permanent cardiac pacemaker implantation in patients with severe arrhythmia.Therefore,reasonable interventions can be made clinically based on its influencing factors to reduce the incidence rate of tricuspid regurgitation and promote prognosis.