摘要
目的探讨2009年9月至2012年6月河南省44岁以下的青年急性冠状动脉综合征（ACS）患者，住院期间心律失常的类型特征及危险因素。方法从郑州大学第一附属医院的病历信息系统与远程会诊信息中心调取河南省44岁以下的青年ACS患者及同期住院的中年（n=280）和老年ACS患者（n=190）的信息资料，分析患者心律失常的类型特点；从患者的一般情况、心律失常类型、高血压、空腹血糖、甲状腺疾病、呼吸睡眠暂停综合征、吸烟史、饮酒史、饮食习惯、早发心律失常家族史、实验室检查等分析患者的危险因素。结果（1）近3年，河南省发生ACS的青年患者200例，出现心律失常的110例，明显低于同期因ACS住院的老年患者（55．oo％比71．05％，P〈0．01）。（2）青年ACS患者心律失常中，前3位依次是：窦性心动过速（30．50％）、室性早搏（19．00％）、心房扑动和（或）心房颤动（16．50％）。青年ACS患者和中年ACS患者比较：窦性心动过速、心房扑动和（或）心房颤动的发生率较高（P均〈0．05），室性心动过速、心室颤动、阵发性室上性心动过速发生率较少（P均〈0．05）。青年ACS患者和老年ACS患者比较：窦性心动过速的发生率明显增加（P〈0．01），室性早搏、加速性室性自主心律、室性心动过速、心室颤动、非阵发性室性心动过速、心房扑动和（或）心房颤动、阵发性室上性心动过速、窦性心动过缓、房室交界性逸搏、房室传导阻滞的发生率均较少（P〈0．05或0．01）。（3）青年ACS心律失常组与青年ACS非心律失常组相比，体质指数、吸烟指数、冠状动脉三支病变、饮酒、喜食咸品、甲状腺功能异常、呼吸睡眠暂停综合征等均明显较高（P〈0．05或0．01）。（4）logistic回归分析后发现，与河南省青年ACS患者发生心律失常独立相关的危险因素排名前3位的
Objective The types and risk factors of arrhythmia were analyzed on acute coronarysyndrome （ACS） patients under the age of 44 years who were hospitalized in Henan province between September 2009 to June 2012. Methods Medical records of eligible patients were obtained from the information system of the First Affiliated Hospital of Zhengzhou University teleconsultation information center. Middle aged and elderly ACS patients who were hospitalized at the same period served as controls. Data on arrhythmia types, blood pressure, thyroid disease, respiratory sleep apnea syndrome, smoking history, history of alcohol consumption, eating habits, family history of early-onset arrhythmia, laboratory tests were analyzed. Results （ 1 ） Arrhythmia was detected in 110 out of young ACS patients （ 55 % ）, which was significantly lower than that in the elderly ACS patients （71.05%, P 〈0. 01 ）. （2） The top three arrhythmias in young ACS patients were： sinus tachycardia （30. 50% ）, the premature ventricular contractions （ 19. 00% ）, atrial flutter/atrial fibrillation （ 16. 50% ）. Incidence of sinus tachyeardia, atrial flutter/atrial fibrillation were significantly higher while incidence of ventricular tachycardia, ventrieular fibrillation, paroxysmal supraventricular tachycardia were significantly lower in young ACS patients than in middle-aged ACS patients （ all P 〈 0. 05 ）. The incidence of sinus tachyeardia was higher while incidence of ventricular premature accelerated ventricular spontaneous cardiac rhythm, ventrieular taehycardia, ventricular fibrillation, non-paroxysmal supraventricular tachycardia, atrial flutter/atrial fibrillation, paroxysmal supraventricular tachycardia, sinus bradycardia, nodal escape, atrioventricular block were significantly lower in young ACS patients than in elderly ACS patients （ all P 〈 0.05 ）. （ 3 ） Body mass index, incidence of smoking, coronary three-vessel disease, drinking, eating salty foods, thyroid dysfunction, sleep apnea were significant
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2013年第7期572-576,共5页
Chinese Journal of Cardiology
基金
基金项目：河南省医学科技攻关计划项目（201203041,2011020012）
河南省教育厅科学技术研究重点项目科技攻关计划（13A320443）
郑州大学第一附属医院青年创新基金项目
河南省卫生科技创新型人才工程中青年科技创新人才项目
