摘要
目的探讨ST段抬高型急性心肌梗死(心梗)并发心室颤动(室颤)患者的临床特点。方法选择276例ST段抬高型急性心梗患者作为研究对象,患者均行急诊经皮冠状动脉介入术(PCI)治疗,根据患者PCI血管开通前是否发生室颤分为室颤组(50例)和非室颤组(226例)。比较两组临床资料,心梗位置与冠脉病变情况,心功能指标与心损指标,预后。结果室颤组和非室颤组性别和入院时舒张压水平无显著差异(P>0.05)。室颤组患者年龄(69.58±11.02)岁、合并高血压占比72.00%、合并糖尿病占比36.00%、入院时心率(89.36±5.28)次/min、Killip分级>Ⅱ级占比34.00%、合并心房纤颤占比20.00%和入院时收缩压(135.26±25.13)mm Hg(1 mm Hg=0.133 kPa)显著高于非室颤组的(59.03±13.25)岁、50.44%、22.12%、(78.63±8.23)次/min、19.03%、2.65%、(120.36±14.25)mm Hg(P<0.05)。室颤组心梗位置中前壁占比74.00%显著高于非室颤组的40.71%,下壁占比18.00%显著低于非室颤组的38.05%(P<0.05);室颤组冠脉病变部位中左前降支占比62.00%显著高于非室颤组的42.04%(P<0.05);室颤组冠脉病变数目3支占比24.00%显著高于非室颤组的5.75%(P<0.05)。两组左心室收缩末期内径比较,差异无统计学意义(P>0.05)。室颤组肌酸激酶同工酶(CK-MB)峰值(356.36±25.13)U/L、血浆N端脑钠肽前体(NT-proBNP)(1856.56±425.26)ng/L、血清肌钙蛋白I(cTnI)(15.26±1.25)ng/L显著高于非室颤组的(275.13±31.25)U/L、(958.37±142.01)ng/L、(7.45±1.76)ng/L,左心室舒张末期内径(39.02±4.25)mm、左心房内径(44.07±5.69)mm显著大于非室颤组的(31.25±5.13)、(35.29±7.24)mm,左心室射血分数(46.45±9.68)%、二尖瓣口舒张早期血流速度峰值(E)与舒张晚期血流速度峰值(A)比值(E/A)(0.89±0.17)显著低于非室颤组的(54.02±11.52)%、(1.23±0.24)(P<0.05)。追踪患者预后至2023年5月,室颤组死亡率16.00%(8/50)显著高于非室颤组3.54%(8/226)(χ^(2)=11.640,P<0.05)。结论ST段抬高型�
Objective To explore the clinical characteristics of patients with ST-segment elevation acute myocardial infarction complicated with ventricular fibrillation.Methods 276 cases of ST-segment elevation acute myocardial infarction patients were selected as the study subjects.All patients were treated with emergency percutaneous coronary intervention(PCI),and they were divided into a ventricular fibrillation group(50 cases)and a non-ventricular fibrillation group(226 cases)according to whether they had ventricular fibrillation before PCI vessel patency.The clinical data of the two groups were compared,including myocardial infarction location and coronary artery lesion,cardiac function index and cardiac damage index,prognosis.Results There were no significant differences in gender and diastolic blood pressure on admission between the ventricular fibrillation group and non-ventricular fibrillation group(P>0.05).In the ventricular fibrillation group,the age of patients was(69.58±11.02)years old,72.00%of patients with hypertension,36.00%of patients with diabetes mellitus,34.00%of patients with heart rate of(89.36±5.28)beats/min on admission,34.00%of patients with Killip grade>Ⅱ,20.00%of patients with atrial fibrillation,and the systolic blood pressure was(135.26±25.13)mm Hg(1 mm Hg=0.133 kPa),which were significantly higher than(59.03±13.25)years old,50.44%,22.12%,(78.63±8.23)beats/min,19.03%,2.65%,and(120.36±14.25)mm Hg in the non-ventricular fibrillation group(P<0.05).The percentage of anterior myocardial infarction in the ventricular fibrillation group was 74.00%,which was significantly higher than 40.71%in the non-ventricular fibrillation group;and the percentage of inferior myocardial infarction was 18.00%,which was significantly lower than 38.05%in the non-ventricular fibrillation group(P<0.05).The percentage of coronary lesions in left anterior descending branch in the ventricular fibrillation group was 62.00%,which was significantly higher than 42.04%in the non-ventricular fibrillation group(P<0.05).The n
作者
蔡悦炜
张嫄怡
CAI Yue-wei;ZHANG Yuan-yi(Emergency Department,the Second People's Hospital of Zhaoqing City,Zhaoqing 526000,China)
出处
《中国现代药物应用》
2024年第3期43-46,共4页
Chinese Journal of Modern Drug Application
基金
肇庆市科技创新指导类项目资助(项目编号:2021040307030)。
关键词
急性心肌梗死
心室颤动
ST段抬高型
临床特点
心功能
经皮冠状动脉介入术
Acute myocardial infarction
Ventricular fibrillation
ST-segment elevation
Clinical characteristics
Cardiac function
Percutaneous coronary intervention
