急性心肌梗死并心源性休克的院内死亡危险因素分析  

Risk factor analysis of in-hospital death in acute myocardial infarction patients complicated with cardiogenic shock

作　　者：刘颖[1] 苏晞[1] 邓成钢[1] 李振[1] 李蓓[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,湖北省430022

出　　处：《中国心血管病研究》2014年第3期231-234,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 分析影响急性心肌梗死（AMI）合并心源性休克（CS）院内死亡的危险因素.方法 选择2008年6月至2012年12月间223例急性心肌梗死合并心源性休克的住院患者,记录患者的相关临床资料,根据住院期间是否死亡分为两组：死亡组和存活组,应用Logistic回归分析评估AMI合并CS患者院内死亡的危险因素.结果 223例AMI合并心源性休克患者中107例死亡,116例存活.与生存组相比,死亡组中年龄≥70岁、糖尿病、陈旧性心梗史、慢性肾功能不全、前壁心肌梗死、未置入IABP、室间隔穿孔、消化道出血比例及入院时心率、左室射血分数、肾小球滤过率差异有统计学意义（P＜0.05）.Logistic多元回归分析发现,年龄≥70岁、糖尿病、前壁心肌梗死、心率快、左室射血分数低、室间隔穿孔、消化道出血为AMI合并CS院内死亡的独立危险因素.结论 对于急性心肌梗死合并心源性休克的患者,年龄≥70岁、糖尿病、前壁心肌梗死、心率快、左室射血分数低、室间隔穿孔、消化道出血为院内死亡的独立危险因素.Objective Study on the risk factors in patients with acute myocardial infarction （AMI） with cardiogenic shock（CS）.Methods Collected clinical data,treatment and prognosis of 223 acute myocardial infarction patients with cardiogenic shock.According to different results during hospitalization,patients were separated into 2 groups：death group and survival group.Results In 223 cases of patients,there were 107 patients in-hospital death （death group） and 116 cases survival （survival group）.Univariate analysis show that the incidence of age≥70 years,diabetes,old myocardial infarction,anterior myocardial infarction,chronic renal insufficiency,no IABP planted,ventriculer septal rupture,gastrointestinal hemorrhage and heart rate was significantly higher in death group compared with survival group,left ventricular ejection fraction （LVEF）,glomerular filtration rate （GFR） were lower than survival group （all P＜0.05）.Logistic regression analysis showed that age≥70 years,diabetes,anterior myocardial infarction,faster heart rate,lower LVEF,ventricular septal rupture,gastrointestinal hemorrhage were independent risk factors.Conclusion Age≥70 years,diabetes,anterior myocardial infarction,faster heart rate,lower LVEF,ventricular septal rupture,gastrointestinal hemorrhage are independent risk factors of in-hospital death of AMI with CS.

关 键 词：急性心肌梗死 心源性休克 院内死亡 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]