徐靖,程澜

• 1:武汉亚洲心脏病医院心内科武汉市第七医院心内科

摘要(Abstract)：

目的分析经皮冠状动脉介入治疗(PCI)急性ST段抬高心肌梗死(STEMI)患者血管再通过程中发生心室颤动(室颤)的相关危险因素。方法纳入2014年7月至2015年7月武汉亚洲心脏病医院收治的起病12 h内行急诊PCI的STEMI患者500例,对14例血管再通过程中发生室颤(室颤组)及486例未发生室颤患者(未室颤组)的临床资料进行比较,采用多元logistic回归分析室颤发生的相关危险因素。结果室颤组既往心肌梗死史、左主干病变、右冠状动脉为罪犯血管、术前TIMI血流0级、术后无复流患者所占比例均显著高于未室颤组,入院时血钾水平显著低于未室颤组,差异均有统计学意义(均P<0.05)。室颤组入院时心电图下壁心肌梗死、下壁伴右心室心肌梗死、ST_(max)>300μV、ST偏移总和>1500μV患者所占比例,既往心电图QRS时限、入院时心电图ST_(max)和ST偏移总和等均显著高于未室颤组,差异均有统计学意义(均P<0.05)。多元logistic回归分析显示,既往心肌梗死史、既往心电图QRS时限延长、PCI术前室颤、症状发作到球囊扩张时间>360 min、左主干病变、右冠状动脉为罪犯血管、下壁心肌梗死、下壁心肌梗死伴右心室心肌梗死、术后无复流、ST_(max)>300μV、ST偏移总和>1500μV是血管再通过程中发生室颤的危险因素;入院时血钾水平偏高、使用阿司匹林和β阻滞药是血管再通过程中发生室颤的保护因素。结论既往心肌梗死史、既往心电图QRS时限延长、PCI术前室颤、症状发作到球囊扩张时间>360 min、左主干病变、右冠状动脉为罪犯血管、下壁心肌梗死、下壁心肌梗死伴右心室心肌梗死、术后无复流、ST_(max)>300μV、ST偏移总和>1500μV、入院时血钾水平偏低、未使用阿司匹林和β阻滞药是STEMI患者血管再通过程中发生室颤的危险因素。

关键词(KeyWords)： 急性ST段抬高心肌梗死;经皮冠状动脉介入治疗;心室颤动

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 徐靖,程澜

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