急性ST段抬高型心肌梗死的梗死部位与并发心脏破裂患者的特征及预后研究

发布时间：2018-07-28 16:56

【摘要】：目的:分析不同部位的急性ST段抬高型心肌梗死与其并发的心脏破裂患者的临床特征及预后。方法:收集2010-01-2015-12于北京安贞医院、北京积水潭医院及保定市第一中心医院确诊为急性ST段抬高型心肌梗死后心脏破裂的患者111例。根据心肌梗死发生的部位,将上述患者分为前壁组(含或不含侧壁)、下壁组(含或不含后壁)、右室组、多室壁组,对存活患者进行跟踪随访,并将不同组别患者的临床资料及预后进行统计分析。结果:心脏破裂患者中,前壁组69例、下壁组19例、右室组13例、多室壁组10例。各组患者的临床资料比较显示,年龄、性别、身高、体重、体质指数、血红蛋白及破裂部位等均存在显著差异。各组患者住院治疗中,替格瑞洛及β受体阻滞剂的使用存在显著性差异。各组患者的住院不良事件发生率均很高,院内总体病死率高达60.4%,组间未见显著性差异。各组心脏破裂距心肌梗死时间中位数为0~3d。存活患者出院30d的总生存率为56.8%。结论:不同梗死部位的急性ST段抬高型心肌梗死并发心脏破裂患者的临床基线特征及预后存在一定差异;心脏破裂患者院内病死率高,预后差,需要早期干预、强化护理和积极治疗。
[Abstract]:Objective: to analyze the clinical features and prognosis of patients with acute ST-segment elevation myocardial infarction and cardiac rupture. Methods: 111 patients with cardiac rupture after acute ST-segment elevation myocardial infarction were collected from Beijing Anzhen Hospital, Beijing Jishuitan Hospital and Baoding first Central Hospital from January to December 2015-12. According to the location of myocardial infarction, the patients were divided into anterior wall group (with or without lateral wall), inferior wall group (with or without posterior wall), right ventricular group and multi-ventricular wall group. The clinical data and prognosis of different groups of patients were analyzed statistically. Results: there were 69 cases in anterior wall group, 19 cases in inferior wall group, 13 cases in right ventricle group and 10 cases in multi-ventricular wall group. There were significant differences in age, sex, height, weight, body mass index, hemoglobin and site of rupture. There were significant differences in the use of tigrilol and 尾-blocker in inpatient treatment in each group. The incidence of adverse events in hospital was very high in each group, the overall fatality rate in hospital was as high as 60.4 and there was no significant difference between the two groups. The median time between cardiac rupture and myocardial infarction in each group was 0 ~ 3 days. The overall survival rate at 30 days after discharge was 56.8%. Conclusion: the clinical baseline characteristics and prognosis of patients with acute ST-segment elevation myocardial infarction complicated with cardiac rupture are different in different infarct sites, the hospital mortality is high, the prognosis is poor, and early intervention is needed. Intensive care and active treatment.
【作者单位】：北京积水潭医院北京大学第四临床医学院干部保健科;首都医科大学附属北京安贞医院急诊危重症中心;保定市第一中心医院心内科;
【基金】：北京市自然科学基金重点项目(No:7141003) 北京市医管局重点医学专业发展计划(No:ZYLX201710) 北京市保健科研课题(京15-12号)
【分类号】：R542.22

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