急性ST段抬高型心肌梗死急诊介入治疗后短期发生心力衰竭的单中心研究

发布时间：2018-05-15 09:00

本文选题：急性ST段抬高型心肌梗死 + 急诊经皮冠状动脉介入治疗　；参考：《临床心血管病杂志》2016年07期

【摘要】：目的:探讨急性ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)术后短期发生心力衰竭(心衰)的因素,为减少急诊PCI术后心衰的发生提供依据。方法:回顾性分析连续收治行急诊PCI的STEMI患者240例的病历资料,分为心衰组(94例)和非心衰组(146例),记录并分析两组患者基线特征、入院临床特征、急诊PCI相关情况,应用Logistic回归分析影响急诊PCI后心衰发生的因素。结果:与非心衰组相比,心衰组患者年龄、糖尿病史、既往心肌梗死病史、典型胸痛、入院血压、B型钠尿肽、入门-球囊扩张时间(DTBT)、应用主动脉球囊反搏泵(IABP)等差异均具有统计学意义(均P0.05)。Logistic回归分析表明:糖尿病史(OR=1.830,95%CI:1.010~3.316,P=0.046)、既往心肌梗死病史(OR=2.587,95%CI:1.149~5.822,P=0.022)是心衰发生的危险因素;典型的胸痛(OR=0.438,95%CI:0.228~0.841,P=0.013)、应用IABP(OR=0.399,95%CI:0.189~0.845,P=0.016)是心衰的保护因素。结论:有糖尿病史、既往发生过心肌梗死的患者容易在急诊PCI后短期发生心衰,应用IABP可有效降低急诊PCI后短期心衰的发生。
[Abstract]:Objective: to investigate the risk factors of heart failure (HF) in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) in order to reduce the incidence of CHF after emergency PCI. Methods: the medical records of 240 consecutive STEMI patients with emergency PCI were analyzed retrospectively. The patients were divided into two groups: heart failure group (n = 94) and non-heart failure group (n = 146). The baseline features, clinical features of admission, and the correlation of emergency PCI were recorded and analyzed. Logistic regression analysis was used to analyze the risk factors of heart failure after emergency PCI. Results: age, history of diabetes, history of myocardial infarction, typical chest pain, admission blood pressure and type B natriuretic peptide in patients with heart failure were compared with those in non-heart failure group. P0.05).Logistic regression analysis showed that the history of diabetes mellitus was 1.83095% (CI: 1.010103.316p 0.046N), and the history of myocardial infarction was 2.58795CIW 1.1495.822P0. 022) was the risk factor of heart failure. The typical chest pain is 0.43895 CI: 0.2280.481P0.013, the application of IABPOR0.399995 CI: 0.18945P0.016) is the protective factor of heart failure. Conclusion: patients with previous myocardial infarction have a history of diabetes, and short-term heart failure is easy to occur after emergency PCI. The use of IABP can effectively reduce the incidence of short-term heart failure after emergency PCI.
【作者单位】：新疆维吾尔自治区人民医院心内科;
【分类号】：R542.22;R541.6

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