急性ST段抬高型心肌梗死并发心源性休克的相关危险因素分析  

The Risk Factors of Cardiogenic Shock after Acute ST-elevation Myocardial Infarction

作　　者：廖祁伟[1] 光雪峰[1] 景舒南[1] 李汝红[1] 赖碁[1] 付娟娟[1] 

机构地区：[1]昆明医科大学附属延安医院心内科,云南昆明650051

出　　处：《昆明医科大学学报》2013年第2期91-95,116,共6页Journal of Kunming Medical University

基　　金：云南省科技厅科研基金重点资助项目(2009CA207)

摘　　要：目的探讨急性ST段抬高型心肌梗死患者并发心源性休克的危险因素.方法以2010年1月至2011年1月期间住院治疗的185急性ST段抬高型心肌梗死患者为研究对象,以是否并发心源性休克为分组标准,对2组患者进行病例对照研究,通过多因素Logistic回归分析筛选出可能引起心源性休克的危险因素.结果通过回归分析,进入回归方程的因素有血压(OR=6.314)、C-TnI(OR=12.932)、BNP(OR=3.523)、广泛前壁心肌梗死(OR=17.241)、冠脉多支血管病变(OR=5.039)、前降支病变(OR=9.955)、左室射血分数(OR=10.022)、室性心律失常(OR=7.513),差异有统计学意义(P>0.05).结论血压、心率、心肌酶(CK-MB)、心肌标志物(C-Tn)I、BNP、左心室射血分数、广泛前壁心肌梗死、前降支病变、多支血管病变、糖尿病史、房颤、左束支阻滞、室性心律失常是急性ST段抬高型心肌梗死患者并发心源性休克的危险因素,急性ST段抬高型心肌梗死患者并发心源性休克治疗关键在于尽早对导致心源性休克的危险因素进行评估,早期采取干预治疗.Objective To analye the risk factors of cardiogenic shock after ST-elevation myocardial infaction Methods 185 patients with acute ST-elevation myocardial infarction during 2010.1.-2011.1 were divided into two groups： group with or without cardiogenic shock. Basic characteristics of each case were record by case control study and variate logistic regression analysis was used to find out the risk factors of cardiogenic shock. Results The regression analysis showed that the factors in the regression equation were Blood Pressure （OR =6.314） , CTnI （OR=12.932） , BNP （OR=3.523） , extensive anterior myocardial infarction （OR=17.241） , multi-vessel coronary disease （OR=5.039）, anterior descendingbranch involvement （OR=9.955）, left ventricularejection fraction （OR= 10.022） and ventricular arrhythmia （OR=7.513）. Conclusions Blood Pressure, Heart rate, CK-MB, CTnI, BNP, left ventricular ejection fraction, extensive anterior myocardial infarction, anterior descending branch involvement, multi-vessel coronary disease, diabetes, atrial fibrillation, left bundle-branch block and ventricular arrhythmia are risk factors of cardiogenic shock after ST-elevation myocardial infaction. It is the key to evaluate the risk factors of cardiaogenic shock and take interventional measures as early as possible for treatment of patients with ST-elevation myocardial infaction and cardiaogenic shock.

关 键 词：急性ST段抬高型心肌梗死 心源性休克 危险因素 

分 类 号：R542.2[医药卫生—心血管疾病]