探讨心内科老年患者治疗期间心源性猝死的临床危险因素江西省安福县人民医院内一科 曾林飞

目的 分析心内科老年心血管疾病患者发生心源性猝死的高危因素。方法 搜集自2016年2月- 2019年8月在本院心内科住院期间发生心源性猝死的患者共68例,作为研究组；搜集同期未发生心源性猝死的心血管疾病患者共145例,作为对照组。收集并比较两组患者的饮酒史、吸烟史、合并症、BMI、年龄、疾病类型等临床资料,展开回顾性分析,采用Logistic分析影响患者发生心源性猝死的高危因素。结果 研究组患者中心率失常、伴高血压、伴高血脂、伴心肌梗塞病史、伴外伤、便秘、瓣膜心脏病和慢性肺病比例、BMI值明显高于对照组,差异具有统计学的意义(P<0.05)；经Logistic分析显示,瓣膜心脏病、高血脂、心肌梗塞病史、慢性肺病、便秘、心率失常、BMI≥28kg/m²均为患者发生心源性猝死的高危因素(P<0.05)。结论 高血脂、心肌梗塞病史、慢性肺病、便秘以及肥胖均会增加老年心血管疾病患者发生心源性猝死的风险性,在治疗时需早期评估心内科老年患者的心源性猝死风险,指导患者调整生活习惯,控制合并症,预防猝死的发生。

The exploration of the clinical risk factors of sudden cardiac death in elderly patients during treatment at cardiology department

Objective To analyze the high risk factors of sudden cardiac death in elderly patients with cardiovascular diseases at cardiology department. Methods 68 patients with sudden cardiac death in our hospital from February 2016 to August 2019 were selected as the study group, and 145 patients with cardiovascular diseases without sudden cardiac death in the same period were collected as the control group. The clinical data of drinking history, smoking history, complications, BMI, age and disease type were collected and compared between two groups. The high risk factors of sudden cardiac death were analyzed by Logistic. Results The proportion of abnormal center rate, hypertension, hyperlipidemia, history of myocardial infarction, trauma, valvular heart disease, chronic pulmonary disease and BMI in study group were significantly higher than those in control group (P<0.05). Logistic analysis showed that valvular heart disease, hyperlipidemia, history of myocardial infarction, chronic pulmonary disease, constipation, arrhythmia, BMI > 28kg/m² were high risk factors for sudden cardiac death (P<0.05). Conclusion Hyperlipidemia, history of myocardial infarction, chronic pulmonary disease, constipation and obesity increase the risk of sudden cardiac death in elderly patients with cardiovascular diseases. It is necessary to evaluate the risk of sudden cardiac death in elderly patients with cardiac diseases in the early stage of treatment, guide patients to adjust their living habits, control complications and prevent sudden cardiac death.