老年冠心病患者发生心律失常类型临床相关因素分析
发布时间：2019-03-29 19:03
【摘要】：目的:分析老年冠心病患者发生房性心律失常及室性心律失常两种心律失常类型与血管病变支数、血浆BNP、血清钾浓度、左心室舒张末期内径及左心室射血分数的关系。方法:634例经结合临床症状及冠状动脉造影诊断为冠心病的老年患者,年龄均大于60岁,根据其临床表现及辅助检查结果,分为急性冠脉综合征(acute coronary syndrome,ACS)和慢性缺血综合征(chronic ischemic syndrome,CIS)两组,记录各组24小时动态心电图变化(Holter)明确24小时内所发生的的心律失常类型,进一步分析两组患者发生房性及室性心律失常类型与血管病变支数、血清钾浓度、血浆BNP值、左心室射血分数、左心室舒张末期内径值的关系。结果:1、老年急性心肌缺血与慢性心肌缺血两组心律失常发生类型:ACS组与CIS组心律失常类型:ACS组患者共有476例,其中,房性期前收缩:144例,房性心动过速38例,心房颤动110例,室性期前收缩138例,室性心动过速34例,心室颤动12例;CIS组患者共有158例,其中,房性期前收缩18例,房性心动过速8例,心房颤动46例,室性期前收缩62例,室性心动过速22例,心室颤动2例。2、老年ACS组心律失常类型(房性及室性)临床相关因素及相关性:(1)血清钾浓度可影响心律失常发生类型:血钾低于正常值时,室性心律失常发生率更高,差异有统计学意义(占67.80%,P0.05)。(2)冠脉多支病变时心律失常的发生率高于单支病变,差异无统计学意义(P0.05)。当BNP升高、LVEF下降及LVDD增大时,房性心律失常发生率高于室性心律失常,差异无统计学意义(P0.05)。3、老年CIS组心律失常类型(房性及室性)临床相关因素及相关性:(1)血浆BNP水平升高、左室射血分数增大及左室舒张末期内径增加可影响心律失常发生类型,发生室性心律失常概率更高,该差异有统计学意义(PO.05)。(2)血钾水平的降低可增加心律失常发生率,但与心律失常类型无相关性(P0.05)。(3)当血管单支病变时,心律失常的发生率更高。结论:1、老年ACS患者中,合并低钾血症,室性心律失常发生率更高;血管病变支数、血浆BNP水平、左室射血分数及左室舒张末期内径的改变不会影响心律失常发生类型。2、老年CIS患者中,血浆BNP水平升高、左室射血分数降低及左室舒张末期内径增加时,室性心律失常发生率更高;血管病变支数及血钾浓度的改变对心律失常类型无明显影响。
[Abstract]:Aim: to analyze the relationship between atrial arrhythmias and ventricular arrhythmias in elderly patients with coronary heart disease (CHD) and the number of vascular branches, plasma BNP, serum potassium concentration, left ventricular end diastolic diameter and left ventricular ejection fraction (LVEF). Methods: 634 elderly patients with coronary heart disease diagnosed by clinical symptoms and coronary angiography were all over 60 years old. According to their clinical manifestations and auxiliary examination results, they were divided into acute coronary syndrome (acute coronary syndrome,). (ACS) and chronic ischemic syndrome (chronic ischemic syndrome,CIS) group, recorded 24 hours dynamic electrocardiogram changes in each group, (Holter) identified the type of arrhythmias that occurred within 24 hours. The relationship between the incidence of atrial and ventricular arrhythmias and the number of vascular lesions, serum potassium concentration, plasma BNP, left ventricular ejection fraction and left ventricular end-diastolic diameter were further analyzed. Results: 1. The types of arrhythmias in elderly patients with acute myocardial ischemia and chronic myocardial ischemia were as follows: ACS group and CIS group: there were 476 patients in ACS group, among them, atrial preatrial contraction: 144 cases, atrial tachycardia 38 cases. There were 110 cases of atrial fibrillation 138 cases of ventricular extrasystole 34 cases of ventricular tachycardia and 12 cases of ventricular fibrillation. In CIS group, there were 18 cases of atrial precontraction, 8 cases of atrial tachycardia, 46 cases of atrial fibrillation, 62 cases of ventricular extrasystole, 22 cases of ventricular tachycardia, 2 cases of ventricular fibrillation, 2 cases of ventricular fibrillation, 22 cases of ventricular tachycardia, 2 cases of ventricular fibrillation, 46 cases of atrial fibrillation, 62 cases of ventricular extrasystole. The clinical related factors and correlation of arrhythmia type (atrial and ventricular) in elderly ACS group were as follows: (1) the concentration of serum potassium could affect the type of arrhythmias: when serum potassium was lower than normal, the incidence of ventricular arrhythmias was higher, and the incidence of ventricular arrhythmias was higher when serum potassium was lower than normal. The difference was statistically significant (67.80%, P0.05). (- 2). The incidence of arrhythmias in multi-vessel coronary artery lesions was higher than that in single-vessel lesions, but there was no significant difference (P0.05). When BNP increased, LVEF decreased and LVDD increased, the incidence of atrial arrhythmias was higher than that of ventricular arrhythmias, and there was no significant difference (P0.05). (1) the increase of plasma BNP level, the increase of left ventricular ejection fraction (LVEF) and the increase of left ventricular end diastolic diameter (LVEDD) may affect the type of arrhythmias. The incidence of ventricular arrhythmias was higher, the difference was statistically significant (PO.05). (- 2), the reduction of serum potassium level could increase the incidence of arrhythmias. However, there was no correlation between arrhythmias (P0.05). (3) and the incidence of arrhythmias was higher in single vessel lesions. Conclusion: 1. The incidence of ventricular arrhythmias is higher in elderly patients with ACS complicated with hypokalemia. The number of vascular lesions, plasma BNP level, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) did not affect the type of arrhythmias. 2. In elderly patients with CIS, the level of plasma BNP increased. When left ventricular ejection fraction decreased and left ventricular end diastolic diameter increased, the incidence of ventricular arrhythmias was higher. The number of vascular lesions and the concentration of potassium in blood had no significant effect on the type of arrhythmias.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4;R541.7
本文编号：2449798
[Abstract]:Aim: to analyze the relationship between atrial arrhythmias and ventricular arrhythmias in elderly patients with coronary heart disease (CHD) and the number of vascular branches, plasma BNP, serum potassium concentration, left ventricular end diastolic diameter and left ventricular ejection fraction (LVEF). Methods: 634 elderly patients with coronary heart disease diagnosed by clinical symptoms and coronary angiography were all over 60 years old. According to their clinical manifestations and auxiliary examination results, they were divided into acute coronary syndrome (acute coronary syndrome,). (ACS) and chronic ischemic syndrome (chronic ischemic syndrome,CIS) group, recorded 24 hours dynamic electrocardiogram changes in each group, (Holter) identified the type of arrhythmias that occurred within 24 hours. The relationship between the incidence of atrial and ventricular arrhythmias and the number of vascular lesions, serum potassium concentration, plasma BNP, left ventricular ejection fraction and left ventricular end-diastolic diameter were further analyzed. Results: 1. The types of arrhythmias in elderly patients with acute myocardial ischemia and chronic myocardial ischemia were as follows: ACS group and CIS group: there were 476 patients in ACS group, among them, atrial preatrial contraction: 144 cases, atrial tachycardia 38 cases. There were 110 cases of atrial fibrillation 138 cases of ventricular extrasystole 34 cases of ventricular tachycardia and 12 cases of ventricular fibrillation. In CIS group, there were 18 cases of atrial precontraction, 8 cases of atrial tachycardia, 46 cases of atrial fibrillation, 62 cases of ventricular extrasystole, 22 cases of ventricular tachycardia, 2 cases of ventricular fibrillation, 2 cases of ventricular fibrillation, 22 cases of ventricular tachycardia, 2 cases of ventricular fibrillation, 46 cases of atrial fibrillation, 62 cases of ventricular extrasystole. The clinical related factors and correlation of arrhythmia type (atrial and ventricular) in elderly ACS group were as follows: (1) the concentration of serum potassium could affect the type of arrhythmias: when serum potassium was lower than normal, the incidence of ventricular arrhythmias was higher, and the incidence of ventricular arrhythmias was higher when serum potassium was lower than normal. The difference was statistically significant (67.80%, P0.05). (- 2). The incidence of arrhythmias in multi-vessel coronary artery lesions was higher than that in single-vessel lesions, but there was no significant difference (P0.05). When BNP increased, LVEF decreased and LVDD increased, the incidence of atrial arrhythmias was higher than that of ventricular arrhythmias, and there was no significant difference (P0.05). (1) the increase of plasma BNP level, the increase of left ventricular ejection fraction (LVEF) and the increase of left ventricular end diastolic diameter (LVEDD) may affect the type of arrhythmias. The incidence of ventricular arrhythmias was higher, the difference was statistically significant (PO.05). (- 2), the reduction of serum potassium level could increase the incidence of arrhythmias. However, there was no correlation between arrhythmias (P0.05). (3) and the incidence of arrhythmias was higher in single vessel lesions. Conclusion: 1. The incidence of ventricular arrhythmias is higher in elderly patients with ACS complicated with hypokalemia. The number of vascular lesions, plasma BNP level, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) did not affect the type of arrhythmias. 2. In elderly patients with CIS, the level of plasma BNP increased. When left ventricular ejection fraction decreased and left ventricular end diastolic diameter increased, the incidence of ventricular arrhythmias was higher. The number of vascular lesions and the concentration of potassium in blood had no significant effect on the type of arrhythmias.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4;R541.7
【相似文献】
相关期刊论文 前10条
1 朱永琴,谢翠珠;80例小儿病毒性心肌炎心律失常类型分析[J];现代中西医结合杂志;2002年12期
2 徐济民;;盲目去颤[J];河南科技参考;1977年06期
3 沈光华;66例肺心病心律失常类型分析[J];苏州医学院学报;1995年01期
4 张进勇;林波;;老年人原发性扩张型心肌病的心律失常类型及其对预后的影响——附31例临床分析[J];工企医刊;1996年01期
5 金鸿奎;吾柏铭;;呼吸衰竭的心律失常类型[J];国外医学参考资料(内科学分册);1976年04期
6 徐济民;;盲目去颤[J];国外医学参考资料.心血管疾病分册;1975年04期
7 李森田,刘春生;小儿病毒性心肌炎心律失常类型临床分析与探讨[J];中医药临床杂志;2005年01期
8 叶裕良;;慢性肺源性心脏病并发心律失常49例临床分析[J];中国医药指南;2011年15期
9 闫睿;;女性房颤可以提前预警[J];中国循证心血管医学杂志;2013年01期
10 石茂静;董蕾;刘浩;郭继鸿;刘元生;;糖尿病与非糖尿病患者发生心律失常类型和危险因素分析[J];中国心脏起搏与心电生理杂志;2012年05期
相关会议论文 前1条
1 王增武;王馨;陈柯萍;邵澜;陈祚;李贤;张澍;中国住院患者心律失常类型调查组;;住院患者心律失常类型调查[A];中华医学会心电生理和起搏分会第八次全国学术年会论文集[C];2008年
相关硕士学位论文 前1条
1 刘娱;老年冠心病患者发生心律失常类型临床相关因素分析[D];吉林大学;2017年
，本文编号：2449798
本文链接：https://www.wllwen.com/yixuelunwen/xxg/2449798.html
最近更新
教材专著
