心功能对血运重建治疗AMI多支血管病变患者预后的影响  

Influence of cardiac function on prognosis in patients with acute myocardial infarction complicating multivessel disease treated by revascularization

作　　者：刘永[1] 葛华[1] 房玲[1] 闫素华[2,3] 

机构地区：[1]沈阳医学院附属中心医院循环内科,辽宁沈阳110024 [2]山东大学医学院,山东济南250012 [3]山东大学附属千佛山医院心内科,山东济南250014

出　　处：《重庆医学》2014年第12期1425-1427,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81070088)

摘　　要：目的探讨心功能对血运重建治疗急性心肌梗死(AMI)多支血管病变(MVD)患者预后的影响。方法将152例行经皮冠状动脉介入(PCI)治疗的AMI合并MVD患者,根据左心室射血分数(LVEF)值分为正常组94例(LVEF≥50%)及降低组58例(LVEF<50%),并就心功能对患者预后的影响进行分析。结果两组患者心肌梗死史、房颤病史、纽约心脏病协会(NYHA)分级、超敏C反应蛋白(hs-CRP)、前降支近端病变(LADp)、支架内再狭窄病变(ISR)、左心室结构及功能比较,差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,NYHA分级、LVEF、左心室质量指数(LVMI)、舒张末期内径(LVEDd)是影响PCI术后患者预后的独立危险因素。结论心功能降低是影响PCI治疗AMI合并MVD预后的危险因素,改善患者心功能将有利于患者预后。Objective To investigate the influence of the cardiac function on the prognosis in the patients with acute myocardial infarction（AM I） complicating multivessel disease （M VD ） treated by revascularization .Methods 152 cases of AM I complicating MVD treated by routine percutaneous coronary intervention （PCI） were divided into the normal group（94 cases ,LVEF≥50% ） and the lower group（58 cases ,LVEF＆lt;50% ） according to the left ventricular ejection fraction （LVEF） ,and the influence of the cardiac function on the prognosis was analyzed .Results The myocardial infarction history ,history of atrial fibrillation ,NYHA classifica-tion ,hs-CRP ,LADp ,ISR ,left ventricular structure and function had statistically significant difference between the two groups （P＆lt;0 .05） .The multivariate Logistic regrossion analysis showed that NYHA classification ,LVEF ,LVMI and LVEDd were the inde-pendent risk factors affecting the prognosis after PCI .Conclusion The reduced cardiac function is a risk factor affecting the prog-nosis of AMI complicating MVD treated by PCI ,the improvement of the cardiac function will be beneficial to the prognosis of the patients .

关 键 词：心肌梗死 心脏功能 血运重建 多支血管病变 

分 类 号：R542.22[医药卫生—心血管疾病]