急诊PCI的STEMI患者入院时心电图缺血程度对术后心源性休克的预测价值分析  

Analysis on Predictive Value of ECG Ischemia Level Upon Hospitalization of STEMI Patients on Postoperative Cardiac Shock

作　　者：杨璇[1] 李长江 李玉 冯磊[1] 曲彦[1] 

机构地区：[1]山东省青岛市市立医院,山东青岛266000 [2]山东省青岛市中心医院 [3]山东省淄博市级机关医院

出　　处：《中国医学创新》2015年第14期28-30,共3页Medical Innovation of China

基　　金：青岛市卫生局课题(2012-WSZD024)

摘　　要：目的:研究急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者入院时心电图缺血程度,分析其对于术后心源性休克的预测价值。方法:选取本院2013年3月-2014年9月收治的发病时间在12 h内的急诊PCI的STEMI患者150例作为研究对象,根据患者入院心电图表现分为2级缺血组(A组)92例与3级缺血组(B组)58例,对比分析两组患者基线资料及TIMI危险评分、PCI后心血管事件发生情况、ST段回落率。结果:A组与B组患者在基线资料方面比较差异无统计学意义(P>0.05);A组ST段回落率>50%明显高于B组,且心血管事件发生率低于B组(P<0.05);经Logistic回归分析,年龄、Killip分级>1级、ST段回落率、3级缺血为PCI术后心源性休克发生的独立因子。结论:急诊PCI的STEMI患者入院时心电图缺血程度3级是术后心源性休克的独立预测因子,对PCI术后病死率及相关并发症具预测价值。Objective：To investigate the ECG ischemia level of patients with acute ST segment elevation myocardial infarction （STEMI） of emergency percutaneous coronary intervention （PCI） during hospitalization and to analyze its predictive value for postoperative cardiac shock.Method：One hundred and fifty patients with STEMI of emergency PCI within 12 hours upon the attack of disease admitted by the hospital from March 2013 to September 2014 were selected as research subjects. They were divided into Group A （ischemia group at level II） with 92 cases and Group B （ischemia group at level III） with 58 cases according to the ECG manifestations at the time of admission, and baseline data, TIMI risk score, occurrence of cardiovascular events after PCI, rate of ST segment resolution of patients in the two groups were compared.Result：The difference in the baseline data of patients in Group A and Group B was not statistically significant （P〉0.05）, The rate of ST segment resolution of patients in Group A was greater than 50%, being significantly higher than that of group B, and the incidence of cardiovascular events of patients in Group A was lower than that of patients in Group B （P〈0.05）. The age, Killip class〉1, rate of ST segment resolution, and ischemia at level III were independent factors for the occurrence of PCI postoperative cardiac shock.Conclusion：ECG ischemia at level III in patients with STEMI of emergency PCI during admission is an independent predictor of postoperative cardiac shock.It delivers predictive value on postoperative fatality rate of PCI and associated complications.

关 键 词：心肌梗死 心源性休克 介入治疗 ST段回落率 

分 类 号：R542.22[医药卫生—心血管疾病]