急性冠脉综合征患者临床特点及与心功能不全发生的关系  

The influence factors in the clinical characteristics in patients with acute coronary syndrome on heart failure

作　　者：王晓萍[1] 吴蔚[1] 邵冰[1] 宋平南[1] 孙琳[1] 

机构地区：[1]沈阳医学院沈洲医院心血管一病房,沈阳110002

出　　处：《广东医学》2013年第10期1526-1528,共3页Guangdong Medical Journal

基　　金：沈阳医学院科技基金资助项目(编号:20101025)

摘　　要：目的研究急性冠脉综合征(ACS)患者临床特点及与心脏不良事件,特别是心功能不全发生的关系。方法 1 000例ACS患者分为不稳定型心绞痛(UA)组(505例)、急性非ST段抬高心肌梗死(NSTEMI)组(260例)和急性ST段抬高心肌梗死(STEMI)组(235例),回顾性分析入选者的住院病历资料,比较3组临床资料、冠状动脉造影结果和支架情况,总结ACS患者特点与心功能不全的关系。结果 STEMI组和NSTEMI组的三支病变、左主干病变、冠状动脉左旋支(LCX)近段病变的比例高于UA组(P<0.05);STEMI组和NSTEMI组的弥漫性病变、次全闭塞和完全闭塞、侧支循环的比例显著高于UA组(P<0.01)。多因素logistic回归分析影响ACS患者发生心功能不全事件的因素是:白细胞数、空腹血糖、入院时心率、三支病变、冠状动脉左前降支(LAD)近段次全闭塞和完全闭塞病变、支架总长度。结论 NSTEMI患者多支血管病变常见,病变范围广,病变程度严重,出院后心功能不全发生率较高;而STEMI对住院期间心功能影响较大。Objective To study the influence factors in the clinical characteristics of ACS patients on heart dysfunction. Methods One thousand patients with ACS were divided into Group UA （ n = 505 ） , Group NSTEMI （ n = 260） and Group STEMI （n = 235 ）. The retrospective analysis was performed base on the clinical characteristics, coronary arteriography, and state of stent. Results There were significantly higher incidences of three branch lesions, left main branch lesion and LCX proximal lesions in both Group STEMI and Group NSTEMI than those in Group UA （ P 〈 0. 05 ） ; so were the incidences of diffuse lesions, subtotal occlusion and complete occlusion, collateral circulation （P 〈 0. 01 ）. According to multivariate logistic regression analysis, the risk factors of heart failure in ACS patients were white blood cell count, elevated fasting blood sugar, admission heart rate, three branch lesions, LAD proximal subtotal occlusion and com- plete occlusion lesion, and stent length. Conclusion Muhivessel, diffused and severe lesions are common in patients with NSTEMI, complicated with high incidence of cardiac dysfunction after discharge; while STEMI significantly affects the cardiac function during hospitalization.

关 键 词：冠状动脉疾病 心功能不全 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]