摘要
目的探讨急性心肌梗死合并射血分数降低的心力衰竭患者行PCI后6个月不良心血管事件发生的影响因素。方法选择2019年1月—2022年1月成都市第三人民医院心内科接诊的急性心肌梗死合并射血分数降低患者112例作为研究对象,所有患者均在医院心内科行PCI治疗,统计患者一般临床资料,随访6个月患者发生不良心血管事件的发生率以及患者预后情况,采用单因素分析联合多因素Logistic回归分析影响患者PCI后不良心血管事件发生的相关因素。结果纳入研究患者心血管不良事件发生主要包括动脉夹层、局部血肿、局部出血、假性动脉瘤、上肢肿痛以及感染,不良事件发生率为36.61%(41/112)。血管不良事件患者中普遍年龄较大,且有不良生活史(78.05%vs.40.85%)、术后抗凝药物使用不规范(68.29%vs.28.17%)、合并基础疾病(56.10%vs.26.76%)比例明显较高,且经多因素Logistic回归分析后上述因素均为不良心血管事件发生的影响因素。ROC分析结果发现,年龄(AUC=0.837)、抗凝药物使用不规范(AUC=0.701)、不良生活史(AUC=0.691)、合并基础疾病(AUC=0.647)对是否易发生不良心血管事件具有一定的预测价值(P<0.05)。结论急性心肌梗死合并射血分数降低的心力衰竭患者年龄、基础病史、不良生活史、凝血药物用药不规范均是影响PCI后不良心血管事件发生的影响因素,可作为判断不良心血管事件发生的重要参考。
Objective To investigate the influencing factors of adverse cardiovascular events 6 months after PCI in patients with heart failure with acute myocardial infarction and decreased ejection fraction.Methods One hundred and twelve patients with acute myocardial infarction(AMI)complicated with decreased ejection fraction who were admitted to the Cardiology Department of Chengdu Third People's Hospital from January 2019 to January 2022 were selected as the study objects.All the patients included in the study were treated by PCI in the cardiology department of the hospital.After the operation,the general clinical data of the patients were counted,and the incidence of adverse vascular events and the prognosis of the patients were followed up,Single factor analysis combined with multivariate Logistic regression analysis was used to analyze the related factors affecting the occurrence of cardiovascular events.Results The incidence of cardiovascular adverse events in patients included in the study mainly included arterial dissection,local hematoma,local bleeding,pseudoaneurysm,upper limb swelling and pain,and infection.The incidence of adverse events was 36.61%(41/112),and patients with vascular adverse events were generally older,The proportion of patients with a history of unhealthy life style(78.05%vs.40.85%),non-standard use of anticoagulant drugs after surgery(68.29%vs 28.17%),and with concomitant underlying diseases(56.10%vs 26.76%)were significantly higher.Through multivariate Logistic regression analysis,it was found that older age,a history of unhealthy life style,non-standard use of postoperative anticoagulants,concomitant underlying diseases,were important influencing factors for the occurrence of adverse neovascular events in patients,After treatment,a retrospective comparison of the prognosis of patients with and without cardiovascular adverse events found that the readmission rate and mortality rate of patients with cardiovascular adverse events were significantly higher than those without cardiovascular adverse events.The difference was statistically significant.Through ROC analysis,it can be seen that age(AUC=0.837),non-standard use of anticoagulant drug(AUC=0.701),unhealthy life style history(AUC=0.691),with underlying diseases(AUC=0.647)were of high predictive value for cardiovascular adverse events(P<0.05).Conclusion The patient's age,basic medical history,unhealthy life style history,non-standard use of anticoagulant drugs are all influencing factors for the occurrence of adverse cardiovascular events after PCI.Therefore,after PCI,it is necessary to timely adjust the treatment plan according to the patient's corresponding conditions to reduce the incidence of adverse cardiovascular events.
作者
刘玲
田芸
袁龙会
巫文丽
杨洋
Liu Ling;Tian Yun;Yuan Longhui;Wu Wenli;Yang Yang(Department of Cardiology,Chengdu Third People's Hospital,Sichuan Province,Chengdu 610000,China)
出处
《疑难病杂志》
CAS
2024年第5期527-531,共5页
Chinese Journal of Difficult and Complicated Cases
基金
四川省卫生计生委科研课题(16PJ042)。
关键词
急性心肌梗死
心力衰竭
射血分数降低型
经皮冠状动脉介入治疗
心血管事件
影响因素
Acute myocardial infarction
Heart failure,decreased ejection fraction
Percutaneous coronary intervention
Cardiovascular events
Influence factor
