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P〈0.05）。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。
Objective：To investigate the influencing factors of short-term heart failure（HF）after primary percutaneous coronary intervention（PCI）for acute ST-segment elevation myocardial infarction（STEMI）and provide the probable ideas for decreasing heart failure after primary PCI.Method：Two hundred and forty consecutive STEMI patients with primary PCI were included and divided into the HF group（n=94）and none-HF group（NHF,n=146）.The baseline characteristics,clinical features,PCI related cases and the influencing factors of HF after primary PCI were analyzed by using binary logistic regression.Result：Significant differences were found in age,diabetes mellitus,previous myocardial infarction,typical chest pain,blood pressure,BNP,door to balloon time（DTBT）,and the application of intra-aortic balloon counterpulsation（IABP）between the two groups（all P0.05）.Binary logistic regression showed that diabetes mellitus（OR=1.830,95%CI 1.010~3.316,P=0.046）and previous myocardial infarction（OR=2.587,95%CI 1.149~5.822,P=0.022）were risk factors,whereas the typical chest pain（OR=0.438,95%CI0.228~0.841,P=0.013）and the application of IABP（OR=0.399,95%CI 0.189~0.845,P=0.016）were protection factors.Conclusion：STEMI patients with diabetes mellitus and previous myocardial infarction suffer from HF easily after primary PCI in short-term,and the application of IABP can effectively reduce the incidence of HF.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2016年第7期674-677,共4页
Journal of Clinical Cardiology
