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心肌梗死急性期合并恶性室性心律失常患者的院内死亡危险因素资料分析 被引量:23

Risk Factor Analysis for In-hospital Death in Patients With Acute Myocardial Infarction Combining Malignant Ventricular Arrhythmia
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摘要 目的:分析心肌梗死急性期合并恶性室性心律失常(MVA漶者的院内死亡危险因素。方法:入选2006—01至2010—12间急性心肌梗死合并MVA的患者224例,平均年龄(60.2±12.1)岁,男性173例。分为存活出院组和院内死亡组。对比两组间临床特征,分析影响存活出院率的相关因素。结果:两组基线状态对比显示,存活出院组男性比例更高,年龄更轻,心功能更好,合并糖尿病及有心绞痛病史者更少,急性心肌梗死发作距MVA间隔时间更短,肌酐平均水平更低,血清钾正常范围但平均水平更低,体表心电图中J波的检出率更低。采用多元Logistic回归分析结果显示,NYHA高于I级(危险比:5.67;95%CI:1.46~22.03;P=0.01),血清肌酐水平高于正常(危险比:5.26;95%CI:2.10—13.17;P〈0.01),心电图存在J波(危险比:4.37;95%CI:1.82~10.48;P=0.01),急性心肌梗死发作距MVA间隔时间超过24小时(1~13天危险比:3.00;95%CI:1.29。6.93;P_0.01。14~30天危险比:3.41;95%CI:1.40—8.31;P〈0.01),均为急性心肌梗死合并MVA患者的院内死亡的独立相关危险因素。结论:心肌梗死急性期合并MVA患者临床心功能越差,合并肾功能不全,体表心电图检出J波,以及MVA发作距离心肌梗死的时间超过24小时,都意味着院内死亡率增加。 Objective: To analyze the risk factors for in-hospital death in patients with acute myocardial infarction (AMI) combining malignant ventricular arrhythmia (MVA). Methods: A total of 224 AMI patients combining MVA treated in our hospital from 2006-01 to 2012-12 were summarized. There were 173 male, and the average age of the patients was at (60.2±12.1) years. The patients were divided into 2 groups, Survival group, n=155 and Death group, n=69. The clinical characteristics and the risk factors for in-hospital death were analyzed and compared between 2 groups. Results: In Survival group, the patients were more male, with younger age and better NYHA class, there were fewer patients with diabetes mellitus and the history of angina. The patients had shorter period from AMI to the first onset of MVA, had lower serum levels of creatinin and K~, lower rate of J wave in ECG. Multivariate logistic analysis revealed that NYHA higher than I, abnormal kidney function, presence of J wave in ECG, the period from AMI to the first onset of MVA longer than 24 hours were the independent risk factors for in-hospital death in AMI patients combining MVA. Conclusion: Higher NYHA class, abnormal kidney function,~ J wave presence in ECG and the period of AMI to the first onset of MVA longer than 24 hours were the risk factors for increasing the in-hospital death in AMI patients combining MVA.
出处 《中国循环杂志》 CSCD 北大核心 2014年第6期420-423,共4页 Chinese Circulation Journal
关键词 急性心肌梗死 恶性室性心律失常 危险因素 J波 院内死亡 Acute myocardial infarction Malignant ventricular arrhythmia Risk Factor J wave In-hospital death
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  • 1Mont L, Cinca J, Blanch P, et al. Predisposing factors and prognostic value of sustained monomorphic ventricular tachycardia in the early phase of acute myocardial infarction. J Am Coll Cardiol, 1996,28: 1670-1676.
  • 2Hatzinikolaou-Kotsakou E, Tziakas D, Hotidis A, et al. Could sustained monomorphic ventricular tachycardia in the early phase of a prime acute myocardial infarction affect patient outcome? J Electrocardiol, 2007,40( 1 ) :72-77.
  • 3Henkel DM, Witt B J, Gersh B J, et al. Ventricular arrhythmias after acute myocardial infarction: A 20-year community study. America Heart Journal,2006,151:806-812.
  • 4Sala MF, Barcena JP, Rota JI, et al. Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction. Clin Cardiol, 2002,25 (7) :328-334.
  • 5Newby KH, Thompson T, Stebbins A, et al. Sustained ventricular arrhythmias in patients receiving thrombolytic therapy incidence and outcomes. Circulation, 1998,98:2567-2573.
  • 6Anderson JL,Karagounis LA, Becker LC ,et al. For the TEAM-3 investigators. TIMI perfusion grade 3 but not grade 2 results in improved outcome after thrombolysis for myocardial infarction: ventriculographic, enzymatic, and electrocardiographic evidence from the TEAM-3 study. Circulation, 1993,87 : 1829-1839.
  • 7Maggioni AP,Zuanetti G,Franzosi MG,et al. Prevalence and prognostic significance of ventficular arrhythmias after acute myocardial infarction in the fibfinolytic Era : GISSI-2 Results. Circulation, 1993,87 : 312-322.
  • 8Solomon SD,Zelenkofske S, McMurray JJ, et al. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure,or both. N Engl J Med,2005 ,352 :2581-2588.
  • 9Moss A J, Zareba W, Hall WJ, et al. Prophylactic implantation of defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med,2002,346:877-883.
  • 10Wyse DG, Friedman PL, Brodsky MA, et al. Life-threatening ventricular arrhythmias due to transient or correctable causes: high risk for death in follow-up. J Am Coll Cardiol, 2001, 38 ( 6 ) : 1718-1724.

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  • 1李学远,田政球,程文林,杜芬.红细胞分布宽度与慢性心力衰竭患者发生恶性心律失常的关系[J].中国老年学杂志,2014,34(11):2950-2951. 被引量:8
  • 2段晨初,谷疆蓉,甄丽娜,刘育.心律平与胺碘酮治疗心律失常疗效比较的Meta分析[J].中国生化药物杂志,2014,34(5):79-82. 被引量:47
  • 3杨红申,张鲁涛,马俊义.心肌肌钙蛋白与急性肺栓塞[J].国外医学(呼吸系统分册),2004,24(5):293-294. 被引量:12
  • 4Sufi F, Khalil I. Faster person identification using compressed ECG in time critical wireless tdecardioiogy applications [J] . Journal of Net- work and Computer Applications, 2011, 34 (1) : 282-293.
  • 5Pathoumvanh S, Airphaiboon S, Hamamoto K, et al. Robustness study of ECG biometric identification in heart rate variability conditions [J] . IEEJ Transactions Electrical and Electronic Engineering, 2014, 9 (3) : 294-301.
  • 6Reyes BA, Posada-Quintero HF, Bales JR, et al. Novel electrodes for underwater ECG monitoring [J] . IEEE Trans Biomed Eng, 2014, 61(6) : 1863-1876.
  • 7Henderson RA,Jarvis C,Clayton T, et al. 10 -Year mortality out- come of a routine invasive strategy versus a selective invasive strat- egy in non - ST - segment elevation acute coronary syndrome : The British Heart Foundation RITA -3 randomized trial [ J ]. J Am Coil Cardiol,2015,66(5) :511 -520.
  • 8Misumida N, Kobayashi A, Saeed M, et al. Neutrophil - to - lym- phocyte ratio as an independent predictor of left main and/or three - vessel disease in patients with non - ST - segment elevation my- ocardial infarction [ J ]. Cardiovase Revase Med, 2015,16 ( 6 ) : 331 -335.
  • 9Vervaat FE, Christensen TE, Smeijers L, et al. Is it possible to dif- ferentiate between Takotsubo eardiomyopathy and acute anterior ST - elevation myocardial infarction [ J ]. J Electrocardiol, 2015,48 (4) :512 -519.
  • 10Neumar EW, Otto CW, Link MS, et al. Part 8: adult advancedcardiovascular life support: 2010 American heart associationguidelines for cardiopulmonary resuscitation and emergency cardio-vascular care[J]. Circulation, 2010, 122(suppl 3): 729-767.

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