摘要
目的探讨急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)术后患者心功能分级与各危险因素之间的关系。方法收集陕西中医药大学第二附属医院AMI急诊时间窗内行PCI术患者61例,根据Killip分级法将患者心功能分为4级,采用R语言3.4.3软件和SPSS 17.0软件对影响其心功能预后的各因素进行综合分析比较。结果心功能4级患者女性偏多,平均年龄为(72.27±9.62)岁,显著高于1、3级患者(P<0.05);心功能3、4级患者血清血浆前体脑钠钛(pro-BNP)水平显著高于心功能1、2级患者(P<0.05);心功能4级同型半胱氨酸、肌钙蛋白T均高于1、2、3级患者(P<0.05);心功能3级患者的白细胞计数高于1、2级患者(P<0.05);心功能4级患者心肌梗死部位多发前臂、或前臂合并下壁,而1、2、3级患者单发下壁、前臂;热图分析提示,pro-BNP为影响AMI患者心功能的重要因素;决策树分析模型预测准确率高达93.44%。结论影响急性心肌梗死PCI术后患者心功能的各因素中,年龄、性别、梗死部位、入院时血糖水平、血清脑钠肽水平、白细胞计数、血清肌酐、肌钙蛋白T、C-反应蛋白、血清同型半胱氨酸等因素与AMI患者心功能分级存在密切关系;其中性别、年龄、脑钠肽水平、肌钙蛋白等因素为重要的独立危险因素,对客观评价患者的心功能具有临床指导意义。
Objective To investigate the relationship between cardiac function and risk factors in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods We recruited 61 patients who underwent PCI during the emergency window of AMI in our hospital.They were divided into 4 grades according to their cardiac function by Killip grading method,and the factors affecting the prognosis of their cardiac function were comprehensively analyzed and compared by using R Language 3.4.3 software and SPSS 17.0 software.Results There were more women with Grade 4 cardiac function,with an average age of(72.27+9.62)years,which was significantly higher than that with Grades 1 and 3(P<0.05).Serum brain natriuretic peptide level in patients with Grades 3 and 4 cardiac function was significantly higher than in those with Grades 1 and 2 cardiac function(P<0.05).Homocysteine and troponin T levels were significantly higher in patients with Grade 4 cardiac function than those with Grades 1,2 and 3(P<0.05).White blood cell count in patients with Grade 3 cardiac function was significantly higher than those with Grades 1 and 2(P<0.05).Grade 4 cardiac function patients had multiple forearm or myocardial infarction in the forearm,while patients with Grades 1,2,and 3 had the condition in a single inferior wall and forearm.Thermography analysis showed that serum brain natriuretic peptide level was an important cardiac function factor for AMI patients,and the accuracy of the decision tree analysis model was as high as 93.44%.Conclusion The risk factors affecting cardiac function in AMI patients after PCI surgery are advanced age,gender,infarct location,blood glucose level at admission,serum brain natriuretic peptide level,white blood cell count,serum creatinine,troponin T,C-reactive protein,C-reactive protein,and serum homocysteine,which are closely related to the dassification of cardiac function in AMI patients.Among them,gender,age,serum brain natriuretic peptide and cardiac troponin are important independent risk factors with clinical significance in guiding objective evaluation of patients cardiac function.
作者
王敏
崔春利
刘世军
邹俊波
刘亚荣
WANG Min;CUI Chun-li;LIU Shi-jun;ZOU Jun-bo;LIU Ya-rong(The Second Affiliated Hospital,Shaanxi University of Traditional Chinese Medicine,Xianyang 712000;Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2018年第6期871-875,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省科技厅社发攻关项目(2015SF-245
2015SF-246)~~
关键词
急性心肌梗死/心功能
PCI术
KILLIP分级
acute myocardial infarction
cardiac function
percutaneous coronary intervention(PCI)
Killip grading
