摘要
目的 探讨急性冠脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术后发生恶性心律失常(MVA)的危险因素.方法 选择2020年7月至2023年7月于咸阳市中心医院就诊的150例行PCI的ACS患者,根据术后是否发生MVA分为观察组(n=42)和对照组(n=108),随访3个月,比较两组的临床资料并分析影响MVA出现的危险因素.结果 PCI术后并发MAV患者预后较差;两组在平均年龄、吸烟、糖尿病、冠脉病变、发病至PCI时间、支架数量、脑钠肽(BNP)、C反应蛋白(CRP)、肌酸激酶同工酶(CK-MB)、白细胞(WBC)表达水平及中性粒细胞计数(NEU)计数比较,差异有统计学意义(P＜0.05).Logistic因素分析发现,合并糖尿病、发病至PCI时间≥6h、冠状动脉多支病变、CRP和BNP升高是ACS患者PCI术后导致出现恶性心律失常的影响因素.结论 合并糖尿病、发病至PCI时间≥6h、冠状动脉多支病变、CRP和BNP水平升高可影响ACS患者PCI术后出现MVA,临床应加强预防措施并积极干预,以减少恶性心律失常的发生,从而改善预后.
Abstract
Objective To investigate the risk factors for malignant ventricular arrhythmia(MVA)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods ACS patients(n=150)undergone PCI were chosen from Central Hospital of Xianyang City from July 2020 to July 2023.All patients were divided,according to whether MVA occurred after PCI or not,into observation group(n=42)and control group(n=108).The patients were followed up for 3 months.The clinical materials were compared between 2 groups,and risk factors affecting MVA occurrence were analyzed.Results The prognosis was poor in MAV patients after PCI.There were significant differences in average age,smoking,diabetes,coronary artery disease,time from disease onset to PCI,the number of stents,expression levels of brain natriuretic peptide(BNP),C-reactive protein(CRP),creatine kinase-MB isoenzyme(CK-MB)and white blood cell(WBC),and neutrophil count(NEUT)between 2 groups(P＜0.05).The results of Logistic analysis showed that complicated diabetes,time from disease onset to PCI≥6 h,multi-vessel lesions of coronary artery,and increased CRP and BNP were influence factors for MVA occurrence in ACS patients after PCI.Conclusion Complicated diabetes,time from disease onset to PCI≥6 h,multi-vessel lesions of coronary artery,and increased CRP and BNPcan affect MVA occurrence in ACS patients after PCI.In clinical practice,preventive measures and actively intervention should be strengthened to reducing MVAoccurrence and improving prognosis.
维普
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