心肌梗死后心脏性猝死危险分层存在的问题及研究进展

摘要

心脏性猝死(SCD)约占心血管病死亡患者例数的一半,冠心病、急性心肌梗死是其主要的发病原因.目前临床上预测心肌梗死后SCD的主要指标为左心室射血分数(LVEF),但是单纯使用LVEF预测SCD的发生具有较低的敏感性及特异性.实际上,约一半的SCD发生于那些LVEF相对保留的患者中,即使在LVEF降低的患者中,也有部分患者并未发生致死性的心律失常事件.并且,除LVEF外亦存在诸多与SCD发生有密切关系的其他因素.因此,建立一个新的SCD风险评估模型,以更加广泛地覆盖各种高危人群,具有重要临床意义.%Sudden cardiac death(SCD)accounts for about half of the number of deaths in patients with cardiovascular disease,and coronary heart disease,acute myocardial infarction are the main cause of the disease.At present,the main indi-cator of SCD after myocardial infarction is left ventricular ejection fraction(LVEF),but the use of LVEF alone to predict the occurrence of SCD has a low sensitivity and specificity.In fact,about half of the SCD occurred in patients with relative LVEF retention,and even in patients with reduced LVEF,some patients did not develop fatal arrhythmia. In addition to LVEF there are many other factors that are closely related to the occurrence of SCD. Therefore,the establishment of a new SCD risk assessment model to more widely cover a variety of high-risk groups,has great clinical significance.