急性心肌梗死患者冠脉病变程度与住院期间新发房颤的相关性

罗伟刚，任璐*

（宝鸡市中心医院，陕西 宝鸡，721008）

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摘要：

目的 研究急性心肌梗死患者冠脉病变严重程度与住院期间新发房颤的相关性。方法 回顾性分析2015 年8 月至2016 年 11 月我院211 例行经皮冠状动脉介入（PCI）治疗患者的临床资料，患者既往均无房颤病史，将其按住院期间是否出现房颤分为 房颤组（22 例）和窦性心律组（189 例）。比较两组患者的一般资料及病史、住院用药情况、相关检查结果、Gensini 评分，分析 Gensini 评分与住院期间新发房颤的关系。结果 房颤组的前壁心肌梗死率及NT-proBNP 峰值、Gensini 评分均显著高于窦性心 律组，左心房内经大于窦性心律组而LVEF 值低于窦性心律组（P<0.05）。多因素Logistic 回归分析显示，前壁心肌梗死、NT-proBNP 峰值高、左心房内径大、Gensini 评分高均为急性心肌梗死患者住院期间新发房颤的独立危险因素，而LVEF 高为新发 房颤的保护性因素。结论 急性心肌梗死患者住院期间新发房颤与其冠脉病变程度存在相关性，前壁心肌梗死、NT-proBNP 峰值 高、左心房内径大、Gensini 评分高均为急性心肌梗死患者住院期间新发房颤的独立危险因素，而LVEF 高为新发房颤的保护性 因素。

关键词：急性心肌梗死；心房颤动；冠状动脉病变；Gensini 评分

中图分类号：R542.22 文献标志码：A文章编号：2096-1413(2018)03-0003-03

Correlation between severity of coronary artery lesion and new onset of atrial fibrillation during hospitalization in patients with acute myocardial infarction
LUO Wei-gang, REN Lu *
(Baoji Central Hospital, Baoji 721008, China)

ABSTRACT: Objective To investigate the correlation between severity of coronary artery lesions and new onset of atrial fibrillation during hospitalization in patients with acute myocardial infarction. Methods The clinical data of 211 patients undergoing percutaneous coronary intervention (PCI) in our hospital from August 2015 to November 2016 were analyzed retrospectively. All patients had no previous history of atrial fibrillation. According to whether there was atrial fibrillation during hospitalization, they were divided into atrial fibrillation group (n=22) and sinus rhythm group (n=189). The general information and history of patients, hospitalization, related test results, Gensini scores in the two group were compared, the relationship between Gensini score and new-onset atrial fibrillation during hospitalization were analyzed. Results The anterior wall myocardial infarction rate, NT-proBNP peak and Gensini score in the atrial fibrillation group were significantly higher than those in the sinus rhythm group, the left atrium diameter was larger than that in the sinus rhythm group, while LVEF was lower than that in the sinus rhythm group (P<0.05). Multivariate Logistic regression analysis showed that the anterior myocardial infarction, high NT-proBNP peak, large left atrium diameter and high Gensini score were the independent risk factors of new-onset atrial fibrillation during hospitalization in patients with acute myocardial infarction, while the high LVEF was a protective factor of new onset atrial fibrillation. Conclusion There is a correlation between the severity of new onset atrial fibrillation and the severity of coronary artery disease in patients with acute myocardial infarction. The anterior myocardial infarction, large NT-proBNP peak, large left atrium diameter and high Gensini score are the independent risk factors of new onset atrial fibrillation, while the high LVEF is a protective factor of new onset atrial fibrillation.
KEYWORDS: coronary artery lesion; atrial fibrillation; coronary artery disease; Gensini score

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