急性ST段抬高型心肌梗死患者介入治疗后心律失常发生的影响因素

Influencing factors of arrhythmia after interventional therapy in patients with acute ST segment elevation myocardial infarction

目的探讨急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后发生心律失常的影响因素。方法选取2018年12月至2020年12月许昌市中心医院接收的102例急性STEMI患者作为研究对象,男56例、女46例。设计患者基线资料填写表并记录研究所需资料,统计介入治疗后心律失常发生情况,将可能的影响因素纳入,分析可能导致患者介入治疗后心律失常发生的影响因素。结果102例急性STEMI患者PCI术后发生心律失常48例,发生率为47.06%。发生组糖尿病、高血压、Killip分级和发病至PCI时间与未发生组比较,差异均有统计学意义(均P<0.05);组间其他因素对比,差异均无统计学意义(均P>0.05)。logistic回归分析结果显示,合并糖尿病、高血压、Killip分级Ⅲ或Ⅳ级、发病至PCI时间长是急性STEMI患者PCI术后发生心律失常的危险因素(均OR>1,P<0.05)。结论急性STEMI患者介入治疗后发生心律失常与合并糖尿病、高血压、Killip分级Ⅲ或Ⅳ级、发病至PCI时间长有关,临床可据此制定针对性方案,以降低术后心律失常的发生率。

Objective To investigate the influencing factors of arrhythmia after percutaneous coronary intervention(PCI)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 102 patients with acute STEMI received by Xuchang Central Hospital from December 2018 to December 2020 were selected as the research subjects,including 56 males and 46 females.The baseline data filling form of patients was designed and the data required for the study were recorded.The occurrence of arrhythmia after interventional therapy was counted,the possible influencing factors were included,and the influencing factors that might lead to arrhythmia of patients after interventional therapy were analyzed.Results Among 102 patients with acute STEMI,48 cases had arrhythmia after PCI,with an incidence of 47.06%.There were statistically significant differences in diabetes,hypertension,Killip grade,and time from the onset to PCI between the occurrence group and the non-occurrence group(all P<0.05),and there were no statistically significant differences in other factors between the two groups(all P>0.05).Logistic regression analysis showed that diabetes,hypertension,Killip gradeⅢorⅣ,and long time from the onset to PCI were risk factors of arrhythmia after PCI in patients with acute STEMI(all OR>1,P<0.05).Conclusions Arrhythmia after interventional therapy in acute STEMI patients is related to diabetes,hypertension,Killip gradeⅢorⅣ,and long time from the onset to PCI.According to this,a clinically targeted program can be formulated to reduce the incidence of postoperative arrhythmia.