目的:探讨ST段抬高型急性心肌梗死(STEMI)患者行急诊经皮冠状动脉介入术(PCI)后高危室性心律失常(HRVA)的危险因素.方法:回顾性分析176例行PCI治疗的STEMI患者的临床资料,根据术后有无HR-VA分为HRVA组(34例)和无HRVA组(142例),通过单因素和多因素Logistic回归分析法分析HRVA发生的危险因素.结果:与无HRVA组比较,HRVA组血肌酐[(86.43±21.26)mmol/L比(96.67±20.85)mmol/L]、糖化血红蛋白[(6.13±1.53)%比(6.75±0.74)%]、白细胞计数[(10.09±3.34)×109/L比(11.73±3.42)×109/L]、KillipⅥ级比例(2.94%比14.7%)明显升高,低密度脂蛋白-胆固醇水平[(3.16±0.92)mmol/L比(2.75±0.87)mmol/L]明显降低(P<0.05或<0.01);多因素Logistic回归分析结果显示,糖化血红蛋白、白细胞计数、心功能Killip分级、肌酐是STEMI患者PCI术后发生HRVA的独立危险因素(OR=4.012~7.145,P<0.05或<0.01).结论:糖化血红蛋白、白细胞计数、心功能分级、肌酐与STEMI患者急诊PCI术后高危室性心律失常密切相关,及时给予相应处理,可减少其发生.%Objective:To explore risk factors for high risk ventricular arrhythmias (HRVA)after emergency percuta-neous coronary intervention (PCI)in patients with ST elevation acute myocardial infarction (STEMI).Methods:The clinical data of 176 STEMI patients undergoing PCI were retrospectively analyzed.According to presence or not of HRVA after PCI,they were divided into HRVA group (n=34)and no HRVA group (n=142).Single factor and multifactor Logistic regression analysis were used to analyze risk factors for HRVA.Results:Compared with no HRVA group,there were significant rise in levels of serum creatinine [SCr,(86.43±21.26)mmol/L vs.(96.67± 20.85)mmol/L],glycosylated hemoglobin A1 [HbA1c,(6.13 ± 1.53)% vs.(6.75 ±0.74)%],white blood cell count [(10.09±3.34)109/L vs.(11.73±3.42)109/L]and percentage of Killip class VI (2.94% vs.14.7%),and significant reduction in level of low density lipoprotein cholesterol [(3.16±0.92)mmol/L vs.(2.75±0.87)mmol/L]in HRVA group,P <0.05 or <0.01;multifactor Logistic regression analysis indicated that HbA1c,white blood cell count,cardiac function Killip class and SCr were independent risk factors for HRVA after PCI in STEMI pa-tients (OR=4.012~7.145,P <0.05 or <0.01).Conclusion:Glycosylated hemoglobin A1,white blood cell count, cardiac function grading and creatinine are closely correlated with occurrence of HRVA after emergency PCI in STEMI patients.Timely treatment can reduce occurrence of HRVA.
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