急性下壁心肌梗死患者行急诊PCI术中发生室性心动过速和心室纤颤的预测因素分析

赵甜甜; 何壹娜

doi:10.13201/j.issn.1009-5918.2020.05.006

急性下壁心肌梗死患者行急诊PCI术中发生室性心动过速和心室纤颤的预测因素分析

赵甜甜^,,
何壹娜

- 南充市中心医院急诊科(四川南充, 637000)
基金项目:
四川省科研课题项目(No:19PJ010)

详细信息

通讯作者: 赵甜甜,E-mail:392952481@qq.com

中图分类号: R542.22

收稿日期: 2020-02-20

Predictors of ventricular tachycardia/fibrillation during emergency PCI in patients with acute inferior myocardial infarction

ZHAO Tiantian^,,
HE Yina

- Department of Emergency, Nanchong Central Hospital, Nanchong, Sichuan, 637000, China

More Information

Corresponding author: ZHAO Tiantian, E-mail: 392952481@qq.com

Received Date: 20 February 2020

摘要

摘要: 目的:探讨急性下壁心肌梗死患者行急诊经皮冠脉介入治疗(PCI)术中发生室性心动过速/心室纤颤的预测因素。方法:选取本院收治的450例行急诊PCI术的急性下壁心肌梗死患者作为研究对象,根据术中是否发生室性心动过速/心室纤颤分为观察组(42例)和对照组(408例)。对两组患者的冠脉病变特点、冠脉评分、临床资料等进行对比分析。结果:观察组的高血栓负荷、TIMI分级0级、罪犯血管RCA占比均显著高于对照组,Gensini评分、IS值均显著高于对照组,血钾水平明显低于对照组(P<0.05)。多因素回归分析显示罪犯血管RCA、TIMI 0级、Gensini评分、高血栓负荷、IS、血钾均是PCI术中发生室性心动过速/心室纤颤的危险因素(P<0.05)。TIMI 0级、罪犯血管RCA、Gensini评分、高血栓负荷、IS、血钾均对急诊PCI术中发生室性心动过速/心室纤颤有一定的预测价值(均P<0.05),其中Gensini评分、血钾有中等预测价值(AUC值分别为0.796、0.721),TIMI 0级、罪犯血管RCA、高血栓负荷、IS的预测价值偏低(AUC值分别为0.624、0.689、0.603、0.658)。结论:急性下壁心肌梗死患者行急诊PCI术中发生室性心动过速/心室纤颤与罪犯血管为RCA、TIMI 0级、高RI、低血钾、高Gensini评分、高血栓负荷密切相关,临床可通过监测上述因素来预测急性下壁心肌梗死患者急诊PCI术中发生室性心动过速/心室纤颤的风险。
- 经皮冠脉介入治疗 /
- 室性心动过速 /
- 心室纤颤 /
- 急性下壁心肌梗死 /
- 预测因素
Abstract: Objective: To explore the predictors of ventricular tachycardia/fibrillation in patients with acute inferior myocardial infarction undergoing emergency percutaneous coronary intervention(PCI). Method: Four hundred and fifty patients with acute inferior myocardial infarction undergoing PCI were divided into two groups according to whether there was ventricular tachycardia or fibrillation during the operation: the observation group(42 cases) and the control group(408 cases). The characteristics of coronary lesions, coronary score and clinical data were compared between the two groups. Result: The high thrombus load, TIMI grade 0, RCA ratio of culprit blood vessels in the observation group were significantly higher than those in the control group, the Gensini score and IS value were significantly higher than those in the control group, and the blood potassium level was significantly lower than that in the control group(P<0.05). Multivariate regression analysis showed that RCA, TIMI grade 0, Gensini score, high thrombus load, IS and blood potassium were all risk factors of VT/VF during PCI(P<0.05). TIMI 0, RCA of culprit's blood vessel, Gensini score, high thrombus load, IS and blood potassium all have certain predictive value for the occurrence of ventricular tachycardia/fibrillation during emergency PCI(P<0.05), among which Gensini score and blood potassium have medium predictive value(AUC value were 0.796 and 0.721 respectively), TIMI 0, RCA of culprit's blood vessel, high thrombus load and IS have low predictive value(AUC value score were 0.624, 0.689, 0.603 and 0.658 respectively).Conclusion: Ventricular tachycardia/fibrillation in patients with acute inferior myocardial infarction during PCI is closely related to RCA, TIMI 0, high RI, low potassium, high Gensini score and high thrombus load of culprit vessels. The risk of ventricular tachycardia/fibrillation in patients with acute inferior myocardial infarction during PCI can be predicted by monitoring the above factors.
- percutaneous coronary intervention /
- ventricular tachycardia /
- ventricular fibrillation /
- acute inferior myocardial infarction /
- predictors

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