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目的:研究早发冠心病合并心律失常的临床特征及两年随访结果。方法:将339例早发冠心病患者按是否合并心律失常分为心律失常组(n=85)和非心律失常组(n=254),对两组患者的临床危险因素及6、12及24个月随访结果进行分析。结果:心律失常组患者急性心肌梗死(49.4%比15.7%)、高血压病(87.1%比76.8%)、吸烟比例(42.4%比30.7%)高于非心律失常组(P<0.05),平均左室射血分数低于非心律失常组(0.55±0.10比0.63±0.09,P<0.05),病变累及左主干(8.2%比0.4%)、左回旋支(55.3%比34.6%)、右冠状动脉(70.6%比44.8%)比例高于非心律失常组(P<0.05),患者6个月(15.3%比7.9%)、12个月(22.4%比8.7%)及24个月(29.4%比12.2%)再发心绞痛、再发心肌梗死、心衰再住院、脑梗死及心源性死亡的复合终点事件发生率较非心律失常组升高(P<0.05)。结论:早发冠心病合并心律失常的患者急性心肌梗死、高血压病、吸烟史比例高于无心律失常的患者,平均左室射血分数较低,预后较差。
Objective: To study the clinical characteristics of early-onset coronary heart disease with arrhythmia and the results of two-year follow-up. Methods: 339 patients with premature coronary heart disease were divided into arrhythmia group (n = 85) and non-cardiac arrhythmia group (n = 254) according to their arrhythmia. The clinical risk factors and 6, 12 and 24 Month follow-up results were analyzed. Results: The rates of acute myocardial infarction (49.4% vs 15.7%), hypertension (87.1% vs 76.8%) and smoking (42.4% vs. 30.7%) in patients with arrhythmia were significantly higher than those in nonarranged patients (P <0.05) Left ventricular ejection fraction was lower in the non-arrhythmic group (0.55 ± 0.10 vs. 0.63 ± 0.09, P <0.05). The lesion involved the left main trunk (8.2% vs 0.4%), the left circumflex branch (55.3% vs. 34.6% The proportion of arteries (70.6% vs 44.8%) was higher in non-arrhythmic groups (P <0.05), with 6 months (15.3% vs 7.9%), 12 months (22.4% vs 8.7%) and 24 months (29.4% (P <0.05). The incidence of combined end points of recurrent angina, recurrent myocardial infarction, re-hospitalization of heart failure, cerebral infarction and cardiogenic death was higher than that of non-cardiac arrhythmia group (12.2% vs 12.2%). Conclusions: Patients with premature coronary heart disease complicated with arrhythmia have a higher rate of acute myocardial infarction, hypertension and smoking history than those without arrhythmia, with a lower mean left ventricular ejection fraction and a poorer prognosis.