| 钮黎剑,黄文军,孙 伟,沈 静,卢振华.急性心肌梗死患者合并恶性室性心律失常的危险因素及QRS-T夹角对其的诊断价值分析[J].,2020,(24):4665-4669 |
| 急性心肌梗死患者合并恶性室性心律失常的危险因素及QRS-T夹角对其的诊断价值分析 |
| The Risk Factors of Malignant Ventricular Arrhythmia in Patients with Acute Myocardial Infarction and the Diagnostic Value of QRS-T Angle |
| 投稿时间：2020-05-23 修订日期：2020-06-17 |
| DOI：10.13241/j.cnki.pmb.2020.24.014 |
| 中文关键词: 急性心肌梗死 恶性室性心律失常 危险因素 QRS-T夹角 诊断价值 |
| 英文关键词: Acute myocardial infarction Malignant ventricular arrhythmia Risk factors QRS-T angle Diagnostic value |
| 基金项目:江苏省卫计委干部保健科研项目（BJ160129）；苏州市吴江区"科教兴卫"项目（wwk201710） |
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| 中文摘要: |
| 摘要 目的：探讨急性心肌梗死（AMI）患者合并恶性室性心律失常的危险因素，分析QRS-T夹角对其诊断价值。方法：对2015年8月~2019年8月我院收治的AMI患者120例的临床资料进行回顾性分析，其中合并恶性室性心律失常者作为研究组（n=42），未合并恶性室性心律失常者作为对照组（n=78），应用单因素及多因素Logistic回归分析AMI合并恶性室性心律失常的危险因素，并分析QRS-T夹角对AMI合并恶性室性心律失常的诊断价值。结果：120例患者中42例合并恶性室性心律失常，发生率为35.00%。多因素Logistic回归分析显示，年龄≥70岁、低血钾、Killip分级>II级、肌钙蛋白I（TnI）≥12 ng/mL、左室射血分数（LVEF）<50%、心脏下后壁梗死、窦性心律RR间期标准差（SDNN）≥90 ms、QRS-T夹角>90°是AMI患者合并恶性室性心律失常的危险因素（P<0.05），QRS-T夹角>90°对AMI患者合并恶性室性心律失常诊断的灵敏度为83.33%（35/42）、特异性为93.59%（73/78），准确度为90.00%（108/120）。结论：年龄≥70岁、低血钾、Killip分级>II级、TnI≥12 ng/mL、LVEF<50%、心脏下后壁梗死、SDNN≥90 ms、QRS-T夹角>90°是AMI患者合并恶性室性心律失常的危险因素，QRS-T夹角>90°对AMI患者合并恶性室性心律失常的诊断价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the risk factors of malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI) and analyze the value of QRS-T angle in its diagnosis. Methods: The clinical data of 120 patients with acute myocardial infarction who were admitted to our hospital from August 2015 to August 2019 were analyzed retrospectively, among them, the patients with malignant ventricular arrhythmia served as the study group (n=42), the patients without malignant ventricular arrhythmia served as the control group (n=78), single factor and multiple factor Logistic regression were used to analyze the risk factors of AMI with malignant ventricular arrhythmia, and the diagnostic value of qrs-t angle in AMI with malignant ventricular arrhythmia were analyzed. Results: 42 of 120 patients were complicated with malignant ventricular arrhythmia, the incidence was 35.00%. Logistic regression analysis showed that age≥70 years old, hypokalemia, Killip> grade II, troponin I (TnI)≥12 ng/mL, left ventricular ejection fraction (LVEF) <50%, inferior posterior wall myocardial infarction, sinus rhythm RR interval standard deviation (SDNN)≥90ms, QRS-T angle>90° were risk factors for malignant ventricular arrhythmia in AMI patients(P<0.05). QRS-T angle>90° was the risk factor for malignant ventricular arrhythmia in AMI patients The sensitivity, specificity and accuracy were 83.33% (35/42), 93.59% (73/78) and 90.00% (108/120) respectively. Conclusion: Age≥70 years old, hypokalemia, Killip grade>II, TnI≥12ng/mL, LVEF<50%, inferior posterior wall myocardial infarction, SDNN≥90ms, QRS-T angle >90° are the risk factors of malignant ventricular arrhythmia in AMI patients. QRS-T angle>90° has a good diagnostic value for malignant ventricular arrhythmia in AMI patients. |
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