急性ST段抬高型心肌梗死PPCI后发生再灌注心律失常的危险因素分析

目的分析急性ST段抬高型心肌梗死(STEMI)患者在经直接经皮冠状动脉介入治疗(PPCI)后再灌注心律失常(RA)的发生率及危险因素。方法回顾性分析2018年1月至2019年5月188例经PPCI治疗的STEMI患者的临床资料。利用单因素分析和多因素Logistic回归分析STEMI患者经PPCI治疗后发生RA的危险因素。结果 188例STEMI患者中,87例发生RA设为RA组,未发生RA的101例设为对照组。单因素分析显示,RA组有吸烟史、合并高血压病、合并2型糖尿病、血管开通时间<6 h、合并低钾血症、罪犯血管为右冠患者占比以及肌红蛋白水平高于对照组(P<0.05)。多因素Logistic回归分析显示,合并高血压病、合并2型糖尿病、血管开通时间<6 h、合并低钾血症、罪犯血管为右冠是影响STEMI患者PPCI后发生RA的独立危险因素(P<0.05)。结论对于采取PPCI治疗的STEMI患者,合并高血压病、合并2型糖尿病、血管开通时间<6 h、合并低钾血症、罪犯血管为右冠可增加RA的发生。

Risk factors of reperfusion arrhythmia in patients with acute ST segment elevation myocardial infarction after PPCI

Objective To analyze the incidence and risk factors of reperfusion arrhythmia(RA) in patients with acute ST segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PPCI). Methods The clinical data of 188 patients with STEMI who were treated with PPCI from January 2018 to May 2019 were analyzed retrospectively. Univariate analysis and multivariate Logistic regression analysis were given to explore the risk factors of RA in STEMI patients after PPCI treatment. Results Among 188 patients with STEMI, 87 cases with RA set as RA group and101 cases with out RA set as control group. The Univariate analysis showed that the proportions of patients with smoking history, combination of hypertension disease or type 2 diabetes mellitus, time from onset to PPCI less than 6 hours,combination of hypokalemia and culprit vessel as right coronary artery and myoglobin level in the RA group were higher than those of the control group(P<0.05). The multivariate Logistic regression analysis showed that combination of hypertension disease or type 2 diabetes mellitus, time from onset to PPCI less than 6 hours, combination of hypokalemia and culprit vessel as right coronary artery were independent risk factors for RA after PPCI in STEMI patients(P<0.05). Conclusion For STEMI patients treated with PPCI, RA increased with combination of hypertension disease or type 2 diabetes mellitus, time from onset to PPCI less than 6 hours, combination of hypokalemia and culprit vessel as right coronary artery.