急性ST段抬高型心肌梗死患者急诊PCI治疗后并发心房颤动的相关因素

Related Factors of Atrial Fibrillation after Emergency PCI in Patients with Acute ST Segment Elevation Myocardial Infarction

目的分析急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)治疗后并发心房颤动的影响因素。方法回顾性分析2018年10月至2020年10月淮北市人民医院收治的133例急性STEMI患者的临床资料,患者均在本院完成PCI治疗,且获得6个月随访结果,将随访期间发生心房颤动患者纳入发生组,未发生心房颤动患者纳入未发生组。查阅资料,统计两组患者临床资料,分析急性STEMI患者急诊PCI治疗后并发心房颤动的影响因素。结果纳入的133例急性STEMI患者中,急诊PCI治疗后随访期间发生心房颤动患者20例,占15.04%。发生组的梗死面积大于未发生组[(6.63±0.24)cm^(2)比(6.50±0.21)cm^(2)],心功能Killip分级Ⅲ级患者比例和血清尿酸、同型半胱氨酸(Hcy)、转化生长因子-β(TGF-β)水平均高于未发生组[60.00%(12/20)比30.97%(35/113)、(379±15)μmol/L比(358±18)μmol/L、(18.3±1.7)μmol/L比(15.3±1.6)μmol/L、(30.4±3.0)μg/L比(26.6±2.8)μg/L](P<0.05或P<0.01)。经单项及多元Logistic回归分析显示,心功能Killip分级Ⅲ级、血清尿酸、Hcy、TGF-β水平高是急性STEMI患者急诊PCI治疗后并发心房颤动的影响因素(OR=8.497,95%CI 1.297-55.689;OR=1.080,95%CI 1.013-1.152;OR=3.190,95%CI 1.599-6.363;OR=1.433,95%CI 1.046-1.962)(P<0.05或P<0.01)。结论心功能Killip分级Ⅲ级、血清尿酸、Hcy、TGF-β水平升高是急性STEMI患者急诊PCI治疗后并发心房颤动的影响因素。

Objective To analyze the influencing factors of atrial fibrillation after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods The clinical data of 133 patients with acute STEMI treated in Huaibei People′s Hospital from Oct.2018 to Oct.2020 were retrospectively analyzed.All the patients completed PCI treatment in our hospital and their 6-month follow-up results were obtained,patients with atrial fibrillation during the follow-up were included into an occurrence group and those without atrial fibrillation were included in a non-occurrence group.The data were consulted and the clinical data of the patients in the two groups were counted,and the influencing factors of atrial fibrillation after emergency PCI in patients with acute STEMI were analyzed.Results Among the 133 included patients with acute STEMI,20 cases developed atrial fibrillation during the follow-up after emergency PCI,accounting for 15.04%.The infarct area in the occurrence group was larger than that in the non-occurrence group[(6.63±0.24)cm^(2) vs(6.50±0.21)cm^(2)],the proportion of patients with Killip gradeⅢof cardiac function and the levels of serum uric acid,homocysteine(Hcy)and transforming growth factor-β(TGF-β)were higher than those in the non-occurrence group[60.00%(12/20)vs 30.97%(35/113),(379±15)μmol/L vs(358±18)μmol/L,(18.3±1.7)μmol/L vs(15.3±1.6)μmol/L,(30.4±3.0)μg/L vs(26.6±2.8)μg/L](P<0.05 or P<0.01).After the preliminary comparison of the general data of the two groups,the eligible variables were included,and single and multiple Logistic regression analysis showed that Killip gradeⅢof cardiac function,high levels of serum uric acid,Hcy and TGF-βwere the influencing factors of atrial fibrillation after emergency PCI in patients with acute STEMI(OR=8.497,95%CI 1.297-55.689;OR=1.080,95%CI 1.013-1.152;OR=3.190,95%CI 1.599-6.363;OR=1.433,95%CI 1.046-1.962)(P<0.05 or P<0.01).Conclusion Killip gradeⅢof cardiac function,high levels of serum uric acid,Hcy and TGF-βare the influencing factors of atrial fibrillation after emergency PCI in patients with acute STEMI.