急性心肌梗死并发心源性休克的住院死亡率危险因素分析  

Risk factors associated with in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock

作　　者：夏雪[1] 朱千里[1] 郑再星 黄伟剑[1] 

机构地区：[1]温州医科大学附属第一医院心内科,325000

出　　处：《心电与循环》2014年第6期479-482,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨急性心肌梗死并发心源性休克患者住院死亡率的危险因素，为临床识别高危患者提供依据。方法回顾性分析89例急性心肌梗死合并心源性休克的患者资料，应用单变量及多变量logistic回归分析其基线特征因素和治疗因素与住院死亡率的关系。结果急性心肌梗死并发心源性休克患者的住院死亡率为51.7％（46例）。其中病死组平均年龄[（74.1±10.1）岁]高于非病死组平均年龄[（66.8±11.4）岁]，急诊PCI比例[10例（21.7%）]低于非病死组[26例（60.5%）]，差异均有统计学意义（均P＜0.05）。多因素logistic回归分析显示年龄（OR=2.109，95％CI：1.29～3.44）、持续性室性心动过速/心室颤动（OR=4.831，95％CI：1.05～22.26）及急诊冠状动脉血运重建（OR=0.171，95％CI：0.06～0.48）与住院死亡率显著相关（均P＜0.05）。结论高龄、持续性室性心动过速/心室颤动是急性心肌梗死合并心源性休克患者住院死亡率增加的危险因素，而急诊冠状动脉血运重建则是保护性因素。Objective To explore the risk factors associated with in- hospital mortality in patients with acute myocardial infarction（AMI） complicated by cardiogenic shock（CS）. Methods The data of 89 in- patients with AMI complicated by CS were analyzed retrospectively. Univariate and multivariate logistic regression analysis were performed to identify the association of baseline features and treatment strategies with in- hospital mortality. Results The overal in- hospital mortality of AMI complicated by CS was 51.7%.Mean age was significantly higher and the ratio of primary percutaneous revascularization （PPR） was significantly lower in dead patients （74.1±10.1 years, 21.7%） than survivors （66.8±11.4 years, 60.5%）. Multivariate logistic regression analysis showed that age （OR=2.109, 95%CI：1.29~3.44）, sustained ventricular tachycardia/ventricular fibril ation（OR=4.831, 95%CI：1.05~22.26） and PPR（OR=0.171, 95%CI：0.06~0.48） were significantly correlated with in- hospital mortality. Conclusion Age and sustained ventricular tachycardia/ventricular fibril ation are risk factors associated with increased in- hospital mortality of AMI complicated by CS. PPR may reduce the risk of death.

关 键 词：急性心肌梗死 心源性休克 住院死亡率 

分 类 号：R542.22[医药卫生—心血管疾病]