过度换气综合征患者心律失常危险因素分析

Analysis of risk factors for arrhythmia in patients with hyperventilation syndrome

目的通过对过度换气综合征的患者进行调查从而研究过度换气综合征患者出现心律失常的危险因素。方法对2018年8月至2023年4月在河北医科大学第一医院就诊的493例过度换气综合征患者进行病历分析。根据是否出现心律失常,分为心律失常组和非心律失常组。记录患者的性别、年龄、动脉血电解质、pH值、PO_(2)、PCO_(2)及就诊时的气温、气压、风速、相对湿度、空气质量指数和空气中污染物水平。单因素分析中P<0.05的因素纳入二分类logistic回归,分析心律失常的危险因素,并绘制ROC曲线,计算AUC评估模型检验能力。结果根据诊断和入选标准,共纳入493例患者,其中男性101例,占20.5%;女性392例,占79.5%。单因素分析显示:性别、年龄、年龄亚组、二氧化硫、心悸和呼吸困难在心律失常组与非心律失常组之间差异有统计学意义(P<0.05)。二分类logistic回归分析结果表明,性别是心律失常的独立危险因素,呼吸困难和心悸是心律失常的影响因素(P<0.05)。ROC曲线及AUC分析显示:心律失常的预测指标为性别、心悸和呼吸困难,三因素联合预测价值最高(AUC 0.752,95%CI 0.696~0.807)。结论在过度换气患者中女性、呼吸困难和心悸是心律失常的独立危险因素。

Objective To analyze the risk factors for arrhythmia in patients with hyperventilation syndrome by investigating the patients with hyperventilation syndrome.Methods The medical records of 493 patients with hyperventilation syndrome who attended the First Hospital of Hebei Medical University from August 2018 to April 2023 were analyzed.They were categorized into arrhythmia and non-arrhythmia groups according to the presence or absence of arrhythmia.The patients'sex,age,arterial blood electrolytes,pH,PO_(2),and PCO_(2) were recorded,as well as the temperature,barometric pressure,wind speed,relative humidity,air quality index,and airborne pollutant levels at the time of consultation.Factors with P<0.05 in univariate analysis were included in binary logistic regression to analyze risk factors for arrhythmia,and ROC curves were plotted,and AUC was calculated to assess the ability of the model to test.Results A total of 493 patients were included according to the diagnostic and enrollment criteria,including 101 men(20.5%)and 392 women(79.5%).Univariate analysis of factors showed that sex,age,age subgroups,sulfur dioxide,palpitations,and dyspnea differed statistically between the arrhythmia group and the non-arrhythmia group(P<0.05).The results of binary logistic regression analysis showed that gender was an independent risk factor for arrhythmia,and dyspnea and palpitations were influential factors for arrhythmia(P<0.05).The ROC curve and AUC analysis showed that the predictors of arrhythmia were gender,palpitations,and dyspnea,and that the combined predictive value of the three factors was the highest(AUC O.752,95%CI 0.696-0.807).Conclusion In hyperventilated patients,female,dyspnea and palpitations were independent risk factors for arrhythmia.