合并心力衰竭的高血压患者发生心律失常相关因素分析

Analysis of risk factors for arrhythmia in patients with hypertension and heart failure

目的探讨高血压合并心力衰竭患者心律失常的危险因素,为疾病临床防治提供参考。方法选取2018年6月~2020年1月收治的83例高血压合并心力衰竭患者为研究对象,予以患者24 h动态心电图,依据室性早搏LOWN分级标准,将患者分为试验组(LOWNⅠ~Ⅴ级,37例)和对照组(LOWN 0级,46例),收集两组临床资料,Logistic回归分析导致患者发生心律失常的危险因素。结果试验组BMI≥24 kg/m^(2)占比高于对照组,FBG、UA、LDH高于对照组,Scr低于对照组(P<0.05);LA与LVEDd高于对照组,LVEF低于对照组,差异有统计学意义(P<0.05)。Logistic回归分析示,肥胖、血UA升高、LA与LVEDd增加、LVEF降低是高血压合并心力衰竭患者并发心律失常的危险因素。结论导致高血压合并心力衰竭患者发生心律失常的危险因素众多,加强体重管理,坚持低嘌呤饮食,合理控制血尿酸,同时加强心电图动态监测与评估,对临床预防和早期识别心律失常的发生具有积极作用。

Objective To explore the risk factors of arrhythmia in patients with hypertension and heart failure,and provide reference for clinical prevention and treatment of the disease.Methods 83 patients with hypertension and heart failure admitted to our hospital from June 2018 to January 2020 were selected as the research subjects,and patients were given a 24-hour dynamic electrocardiogram.According to the LOWN grading standard of ventricular premature beats,the patients were divided into experimental groups(LOWN GradeⅠ~Ⅴ,37 cases)and control group(LOWN grade 0,46 cases),collected two groups of clinical data,Logistic regression analysis caused the risk factors of patients with arrhythmia.Results The proportion of BMI≥24 kg/m^(2) in the experimental group was higher than the control group,FBG,UA and LDH were higher than the control group,Scr was lower than the control group(P<0.05);LA and LVEDd were higher than the control group,LVEF was lower than the control group,the difference was statistical Academic significance(P<0.05).Logistic regression analysis showed that obesity,increased blood UA,increased LA and LVEDd,and decreased LVEF were risk factors for arrhythmia in patients with hypertension and heart failure.Conclusion There are many risk factors for arrhythmia in patients with hypertension and heart failure.Strengthening weight management,adhering to a lowpurine diet,reasonable control of blood uric acid,and strengthening ECG dynamic monitoring and evaluation have a positive effect on clinical prevention and early identification of arrhythmia.