急性前壁心肌梗死急诊介入治疗患者住院期间心力衰竭原因的分析  

Risk factors for heart failure in patients with acute anterior myocardial infarction after PCI

作　　者：宋文奇[1] 高航[2] 司志燕[1] 李臣 

机构地区：[1]邯郸市中心医院,056001 [2]辽宁医学院附属第一医院医务部 [3]秦皇岛市工人医院心内科

出　　处：《中华老年心脑血管病杂志》2014年第1期8-11,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨急性前壁ST段抬高心肌梗死患者行急诊PCI后,发生心力衰竭的危险因素。方法回顾性研究初诊为急性前壁ST段抬高心肌梗死、并行急诊PCI的110例患者,根据是否有心力衰竭,分为心力衰竭组39例和非心力衰竭组71例,比较2组患者临床基础特征,应用logistic回归分析心力衰竭的危险因素。结果心力衰竭组与非心力衰竭组患者年龄、高血压、糖尿病、梗死前心绞痛、发病至手术时间、收缩压、入院血糖、白细胞计数、B型钠尿肽、β受体阻滞剂、术后TIMI血流比较,差异均有统计学意义(P<0.05,P<0.01)。发病至手术时间、年龄、入院血糖、高血压为心力衰竭的危险因素;梗死前心绞痛、术后TIMI血流为心力衰竭的保护因素。结论发病时间长、年龄大,血糖、血压等危险因素越多,术后TIMI血流差,患者心力衰竭的可能性越高。Objective To study the risk factors for heart failure （HF） in patients with acute anteri- or myocardial infarction after PCI. Methods Clinical data about 110 patients with ST-elevated acute anterior myocardial infarction after PCI were retrospectively analyzed. The patients were di- vided into HF group （n=39） and non-HF group （n=71）. Their clinical baseline characteristics were compared. The risk factors for their HF were analyzed by logistic regression analysis. Results Significant differences were found in age, hypertension, diabetes mellitus, pre-infarction angina pectoris,time from symptom onset to operation, systolic pressure, blood glucose at admission, white blood cells, BNP level, β-receptor blocker level and post-operative TIMI flow between the two groups （P〈0.05,P〈0.01）. Time from symptom onset to operation,age, blood glucose at admission and hypertension were the risk factors for HF （P〈0.05）. Pre-infaretion angina pecto- ris and post-operative TIMI flow were its protection factors. Conclusion The more the risk fac- tors for HF （including the disease onset time, age,blood glucose and hypertension） are, the poorer the post-operative TIMI flow is,the easier the HF occurs in patients with acute anterior myocar- dial infarction after PCI.

关 键 词：心肌梗死 心力衰竭 高血压 糖尿病 白细胞计数 年龄因素 危险因素 

分 类 号：R541.6[医药卫生—心血管疾病]