急性心肌梗死患者行经皮冠状动脉介入术后住院期间死亡的危险因素分析  

Risk factors analysis of in - hospital death of acute myocardial infarction patients following percutaneous coronary intervention

作　　者：崔海明[1] 桂艳萍[1] 任雨笙[1] 杨靖[1] 梁春[1] 潘晓明[1] 樊民[1] 顾兴建[1] 吴宗贵[1] 

机构地区：[1]第二军医大学长征医院心血管内科,上海200003

出　　处：《第二军医大学学报》2012年第8期868-871,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨影响急性心肌梗死(AMI)患者行经皮冠状动脉介入术(PCI)后住院期间死亡的危险因素。方法回顾性分析2009年1月至2011年9月因AMI入住我院并行PCI的275例患者的一般情况、既往史、入院情况、术中及术后情况、并发症等资料,对可能影响术后死亡的危险因素通过logistic回归模型进行分析。结果多因素logistic回归分析表明,女性(P=0.047,OR=2.91)、广泛前壁心肌梗死(P=0.044,OR=3.07)、肾功能不全史(P=0.021,OR=7.98)、发生心源性休克(P=0.008,OR=15.71)、术后心肌梗死溶栓(TIMI)血流<3级(P=0.016,OR=5.61)、置入主动脉内球囊反搏(IABP;P=0.043,OR=3.49)。结论影响AMI患者行PCI术后院内死亡的危险因素为女性、广泛前壁心肌梗死、置入IABP、术后TIMI血流<3级、肾功能不全史和发生心源性休克。Objective To explore the risk factors of in-hospital death of acute myocardial infarction（AMI） patients following percutaneous cornary intervenion（PCI）.Methods We retrospectively analyzed the clinical data of 275 AMI patients,including the general condition,medical history,admission,intra-and post-operation condition,and complication.The patients underwent PCI in our hospital from January 2009 to September 2011.Logistic regression analysis was used to predict the risk factor of in-hospital death of AMI patients following PCI.Results Logistic regression analysis found that female sex（P = 0.047,OR = 2.91）,extensive anterior myocardial infarction（P = 0.044,OR = 3.07）,history of renal insufficiency（P = 0.021,OR = 7.98）,cardiogenic shock（P = 0.008,OR = 15.71）,postoperative thrombolysis in myocardial infarction（TIMI） flow grade〈3（P = 0.016,OR = 5.61）,and placement of the intra-aortic balloon pump（IABP,P = 0.043,OR = 3.49） were associated with an increased risk of in-hospital mortality of AMI patients following PCI.Conclusion Female sex,extensive anterior myocardial infarction,placement of the IABP,postoperative TIMI flow grade〈3,history of renal insufficiency,and cardiogenic shock are the risk factors of in-hospital death of AMI patients following PCI.

关 键 词：心肌梗死 经皮冠脉成形术 住院死亡 危险因素 LOGISTIC模型 

分 类 号：R542.22[医药卫生—心血管疾病]