急性冠脉综合征患者入院即刻心率变化的临床意义及相关因素分析

摘要

目的：探讨急性冠脉综合征( ACS)患者入院即刻心率水平变化的特点及其相关因素。方法：253例ACS患者以入院即刻不同心率水平分为<60次/分组、60~69次/分组、70~79次/分组、80~89次/分组、90~99次/分组和≥100次/分组，分析各组患者的基线资料以及不同类型ACS和不同程度冠状动脉病变患者间入院心率水平的差别，并对入院心率水平和入院血糖、C 反应蛋白( CRP )水平以及左室射血分数( LVEF)进行相关性分析。结果：心率≥100次/分的患者，女性所占比例更高，入院血糖和CRP水平更高， LVEF更低。不同类型ACS患者以及不同程度冠状动脉病变患者间入院心率水平比较未发现差异有显著性。 ACS患者的入院静息心率水平与入院CRP水平呈显著正相关，与LVEF呈显著负相关。结论： ACS患者入院心率水平与CRP水平正相关，与LVEF负相关，测定入院静息心率水平可对ACS患者进行初步评估。%Objective To explore the clinical significance and related factors of admission heart rate( HR) in patients with acute coronary syndrome( ACS) . Method A total of 253 patients with ACS in our hospital were enrolled in the study. All the patients were divided into six groups by admission HR:<60,60~69,70~79,80~89,90~99 and≥100 beats/min. Evaluate the baseline information of patients and compare admission HR in different kinds of ACS and patients with different extent of coronary artery lesions. Analyze the relationship between admission HR and the level of admission blood glucose,C-reactive protein( CRP) and left ventricular ejection fraction( LVEF) . Result Pro-portion of female gender,admission blood glucose level and CRP level were significantly higher in patients with ad-mission HR≥100 beats/min,but LVEF was significantly lower(P<0. 05). There was no statistical difference of HR among patients with STEMI,NSTEMI and UAP. The HR difference among patients with different extent of coronary artery lesions was not statistically significant. The admission HR was positively correlated with the CRP level and negatively correlated with LVEF(P<0. 01). Conclusion Admission HR was correlated with the CRP level and LVEF. Patients with ACS can get preliminary evaluation according to the admission HR.