急性心肌梗死患者左室功能影响因素的相关临床研究
发布时间：2018-09-14 10:49
【摘要】：目的：探讨急性心肌梗死患者左室功能的影响因素。 方法：入选2012年1月1日至2012年12月31日因急性心肌梗死（acute myocardialinfarction，AMI）于福建省立医院心内科行急诊或择期冠状动脉介入治疗（percutaneous coronary intervention，PCI）患者共160例，根据发病至PCI时间分为3组，A组：发病12小时内行急诊PCI，B组：发病12小时-7天内PCI，C组：发病8-14天PCI。采用心脏彩色多普勒超声仪测量AMI患者心梗后7-14天的左室射血分数（Left ventricle ejection fraction，LVEF），并将患者的年龄、性别、血压、血糖、吸烟、血脂、肌钙蛋白I值、NT-proBNP值及手术介入时间等与左室射血分数进行相关分析。 结果 1、发病至介入治疗时间（t=－2.354，P=0.02）与AMI患者LVEF值呈负相关。A组的LVEF显著高于C组的LVEF值，差异有统计学意义（P0.05）；A组与B组、B组与C组的LVEF值差异无统计学意义（P0.05）；本组资料中，AMI最常见血管病变为3支血管病变，冠脉单支病变组的LVEF值显著高于冠脉多支病变组的LVEF值，差异有统计学意义（P0.05）。 2、多元回归分析显示在调整其他因素的影响后，肌钙蛋白I值（t=-3.409，P=0.001）、N端-B型钠尿肽前体值（t=-5.484，P=0.000）、空腹血糖异常（t=-2.872，P=0.043）、冠脉病变支数（t=-3.390，P=0.001）与急性心肌梗死患者LVEF值成负相关，高血压病（t=0.052，P=0.959）、糖尿病（t=-0.291，P=0.771）、糖化血红蛋白（t=-1.272，P=0.205）及餐后2小时血糖（t=0.052，P=0.958）、吸烟（t=－0.658，P=0.511）、总胆固醇（t=0.893，P=0.373）、甘油三酯（t=0.711，P=0.478）、低密度脂蛋白胆固醇（t=-0.803，，P=0.423）、高密度脂蛋白胆固醇（t=-1.147，P=0.253）等与急性心肌梗死患者LVEF值无明显相关性。 结论 1、AMI在发病12小时内行PCI术的患者LVEF值保留情况较8天后行PCI术者好；本组资料中，AMI最常见血管病变为3支血管病变，单支血管受累的AMI患者LVEF明显优于多支血管受累者。 2、介入治疗时间、肌钙蛋白I值、N端－B型钠尿肽前体值、空腹血糖异常、冠脉病变数与急性心肌梗死患者LVEF值呈负相关，可以作为梗死后评价心功能的敏感指标及独立的预测因子。
[Abstract]:Objective: to investigate the influencing factors of left ventricular function in patients with acute myocardial infarction. Methods: from January 1, 2012 to December 31, 2012, 160 patients with acute myocardial infarction (acute myocardialinfarction,AMI) underwent emergency or selective coronary intervention therapy (percutaneous coronary intervention,PCI) in the Department of Cardiology, Fujian Provincial Hospital. According to the time from onset to PCI, they were divided into three groups: group A: emergency PCI,B group within 12 hours of onset: PCI,C group within 12 hours to 7 days of onset: PCI. on 8-14 days of onset Left ventricular ejection fraction (Left ventricle ejection fraction,LVEF) was measured 7-14 days after myocardial infarction in patients with AMI by color Doppler echocardiography. Age, sex, blood pressure, blood glucose, smoking, blood lipid were measured. Cardiac troponin I and NT-proBNP were correlated with left ventricular ejection fraction (LVEF). Results (1) the time from onset to interventional therapy (tn 2.354) was negatively correlated with the LVEF value of AMI patients. The LVEF of group A was significantly higher than that of group C (P0.05). There was no significant difference in LVEF between group A and group B and group C (P0.05). Three vessel lesions were the most common vascular lesions in this group. The LVEF value in the single vessel lesion group was significantly higher than that in the multi-vessel coronary artery disease group, and the LVEF value in the single vessel lesion group was significantly higher than that in the multi-vessel coronary artery disease group. The difference was statistically significant (P0.05). 2. Multiple regression analysis showed that after adjusting for other factors, There was a negative correlation between the N-terminal natriuretic peptide precursor (TV-5.484), the abnormal fasting blood glucose (t-2.872), and the number of coronary artery lesion (t-3.390g / P0.001) in patients with acute myocardial infarction (AMI), and the level of troponin I (t-3.409) was negatively correlated with the LVEF value in patients with acute myocardial infarction (AMI). Hypertension (t0. 052), diabetes mellitus (t-0. 291), glycosylated hemoglobin (t-1. 272), postprandial blood glucose (t-0. 052), smoking (t-0. 658P0. 511), total cholesterol (t-0. 893), triglyceride (t-0. 111), low density lipoprotein cholesterol (t-0. 803, P 0. 423), high density lipoprotein cholesterol (t-1. 147, P 0. 253) and other patients with acute myocardial infarction There was no significant correlation between LVEF values. Conclusion (1) the retention of LVEF in patients with PCI within 12 hours after onset is better than that in patients with PCI after 8 days, and the most common vascular lesions in this group are three vessel lesions. LVEF in patients with single vessel involvement was significantly better than that in patients with multiple vessel involvement. 2. Interventional therapy time, cardiac troponin I value, N-terminal natriuretic peptide precursor, fasting blood glucose abnormality, The number of coronary artery lesions was negatively correlated with the LVEF value of patients with acute myocardial infarction, which could be used as a sensitive index and an independent predictor for evaluating cardiac function after infarction.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R542.22
本文编号：2242489
[Abstract]:Objective: to investigate the influencing factors of left ventricular function in patients with acute myocardial infarction. Methods: from January 1, 2012 to December 31, 2012, 160 patients with acute myocardial infarction (acute myocardialinfarction,AMI) underwent emergency or selective coronary intervention therapy (percutaneous coronary intervention,PCI) in the Department of Cardiology, Fujian Provincial Hospital. According to the time from onset to PCI, they were divided into three groups: group A: emergency PCI,B group within 12 hours of onset: PCI,C group within 12 hours to 7 days of onset: PCI. on 8-14 days of onset Left ventricular ejection fraction (Left ventricle ejection fraction,LVEF) was measured 7-14 days after myocardial infarction in patients with AMI by color Doppler echocardiography. Age, sex, blood pressure, blood glucose, smoking, blood lipid were measured. Cardiac troponin I and NT-proBNP were correlated with left ventricular ejection fraction (LVEF). Results (1) the time from onset to interventional therapy (tn 2.354) was negatively correlated with the LVEF value of AMI patients. The LVEF of group A was significantly higher than that of group C (P0.05). There was no significant difference in LVEF between group A and group B and group C (P0.05). Three vessel lesions were the most common vascular lesions in this group. The LVEF value in the single vessel lesion group was significantly higher than that in the multi-vessel coronary artery disease group, and the LVEF value in the single vessel lesion group was significantly higher than that in the multi-vessel coronary artery disease group. The difference was statistically significant (P0.05). 2. Multiple regression analysis showed that after adjusting for other factors, There was a negative correlation between the N-terminal natriuretic peptide precursor (TV-5.484), the abnormal fasting blood glucose (t-2.872), and the number of coronary artery lesion (t-3.390g / P0.001) in patients with acute myocardial infarction (AMI), and the level of troponin I (t-3.409) was negatively correlated with the LVEF value in patients with acute myocardial infarction (AMI). Hypertension (t0. 052), diabetes mellitus (t-0. 291), glycosylated hemoglobin (t-1. 272), postprandial blood glucose (t-0. 052), smoking (t-0. 658P0. 511), total cholesterol (t-0. 893), triglyceride (t-0. 111), low density lipoprotein cholesterol (t-0. 803, P 0. 423), high density lipoprotein cholesterol (t-1. 147, P 0. 253) and other patients with acute myocardial infarction There was no significant correlation between LVEF values. Conclusion (1) the retention of LVEF in patients with PCI within 12 hours after onset is better than that in patients with PCI after 8 days, and the most common vascular lesions in this group are three vessel lesions. LVEF in patients with single vessel involvement was significantly better than that in patients with multiple vessel involvement. 2. Interventional therapy time, cardiac troponin I value, N-terminal natriuretic peptide precursor, fasting blood glucose abnormality, The number of coronary artery lesions was negatively correlated with the LVEF value of patients with acute myocardial infarction, which could be used as a sensitive index and an independent predictor for evaluating cardiac function after infarction.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R542.22
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相关期刊论文 前3条
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