【摘要】 目的 探讨舒张性心力衰竭患者并发心律失常的类型及相关危险因素。方法 入选2015年1月至9月我院急诊科接诊的160例舒张性心力衰竭患者,依据有无心律失常分为心律失常组(108例)与非心律失常组(52例)。对比分析两组患者的临床特征、实验室检查数据以及心律失常组患者的心律失常类型和危险因素。结果 160例舒张性心力衰竭患者中有心律失常的患者占67.50%,非心律失常患者32.50%;心律失常组患者中女性62.04%高于非心律失常组(23.08%);且心律失常患者中年龄≥65岁、有吸烟史、合并肺部感染、伴有基础疾病、系统损害、心包积液、左房扩大所占的比例要明显高于非心律失常组(P<0.05);心律失常组患者的血沉、C反应蛋白、甘油三酯、胆固醇和低密度脂蛋白值均高于非心律失常组患者(P<0.05),而心律失常组患者的高密度脂蛋白、血钾和血钙均低于非心律失常组患者(P<0.05);108例舒张性心力衰竭心律失常患者中心房颤动(房颤)占35.19%,其次是房性早搏(房早)20.37%,室性早搏(室早)17.59%,而窦性心动过速(窦速)、窦性心动过缓(窦缓)、室性心动过速(室速)、房室传导阻碍和室上性心动过速所占比例较低;多元回归分析显示,肺部感染、伴有基础疾病、左房扩大、低钙血症和低钾血症与舒张性心力衰竭患者合并心律失常呈相关性。结论 舒张性心力衰竭患者中以女性、≥65岁、吸烟、合并肺部感染与伴有基础疾病者心律失常多发,其中以房颤、房早与室早为主要类型,而合并肺部感染、伴有基础疾病、左房扩大、低钙血症和低钾血症是发生心律失常的独立危险因素。更多还原

【Abstract】 Objective To analysis the types and risk factors of arrhythmia in patients with diastolic heart failure.Methods We investigated 160 patients with diastolic heart failure from Jan.2015 to Sept.in Peking University People Hospital Emergency Department.These patients were divided into arrhythmia group(n = 108) and non-arrhythmia group(n = 52).Comparative analyses of clinical features and laboratory data of the patients between two groups were performed.The types and the risk factors of arrhythmia were analyzed.Results Patients with cardiac arrhythmias were 67.50%,and non-arrhythmic patients 32.50%in 160 patients with diastolic heart failure,.Female patients in the arrhythmia group were 62.04%,higher than non-arrhythmic(23.08%).In addition,the patients of arrhythmia presented with ≥65 years old,smoking history,pulmonary infection,having underlying disease,system damage,pericardial effusionand left atria enlargementcompared with non-arrhythmic patients(P <0.05).Furemore,arrhythmia patients had higher erythrocyte sedimentation rate,C-reactive protein,triglyceride,cholesterol and low density proteincompared with non-arrhythmia patients(P < 0.05),while the levels of high density lipoprotein,blood potassium and calcium in the arrhythmia group were lower than that in the non-arrhythmia group(P <0.05).Among 108 patients with arrhythmia,the incidence of atrial fibrillation was the highest(35.19%),followed by atria premature contraction(20.37%),ventricular premature contraction(17.59%).Lower prevalence of arrhythmias included sinus tachycardia,sinus bradycardia,ventricular tachycardia,atrioventricular block and supraventricular tachycardia.Conclusion Cardiac arrhythmias in patients with diastolic heart failure are very common,especially atria fibrillation,atria premature,ventricular premature.They are associated with female sex,old age,smokers,pulmonary infection,underlying diseases,left atria enlargement,hypocalcaemia and hypokalemia.更多还原