104例急性冠脉综合征患者PCI术后心力衰竭高危因素分析  

The risk factors of heart failure after PCI treatment in 104 patients with acute coronary syndrome

作　　者：刘红涛[1] 王俊岭[1] 黄雄[1] 张刚[1] 曹雪滨[1] 

机构地区：[1]中国人民解放军第252医院心血管内科(北京军区心血管病研究所),河北保定071000

出　　处：《中西医结合心血管病电子杂志》2015年第30期15-18,共4页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨急性冠脉综合征患者行PCI治疗后发生心力衰竭的高危因素。方法统计心力衰竭组和对照组患者合并高血压、糖尿病病史、吸烟史、陈旧心肌梗死史、既往心力衰竭病史,分析患者冠脉造影影像结果、手术操作时间、对比剂用量及住院期间血糖、血脂、血常规等血液检查指标。结果 104例患者术后发生心力衰竭。心衰组住院时间明显延长、死亡率明显增高。心衰组较对照组手术操作时间明显较长、对比剂用量明显增多、合并糖尿病比率明显升高、累及前降支病变比率明显增多、不稳定型心绞痛比率明显减少、心肌梗死比率明显增加。血液检查指标分析显示,心衰组低密度脂蛋白、肌酐、尿酸、白细胞水平明显高于对照组。多因素Logistic回归分析显示:年龄、前降支病变、白细胞计数、尿酸是ACS患者PCI术后发生心力衰竭的高危因素。结论前降支病变合并入院白细胞计数、尿酸水平明显升高的老年患者为PCI术后发生心力衰竭的高危患者。Objective To investigate the risk factors of heart failure after PCI treatment in patients with acute coronary syndrome.Methods We calculated numbers of patients with histories of hypertension,diabet es,smoking,old myocardial infarction or prior history of heart failure and analyzed their coronary angiography images,the operation time,the amount of contrast agent,blood glucose,blood lipids,and other blood test indicators during hospitalization.Results 104 patients underwent heart failure after PCI in 24 hours~ Compared to control group,patients of heart failure group suffered a longer hospitalization,significantly higher motility.Compared with the control group,heart failure group had longer operation time,more dose of contrast agent,significantly higher ratio of diabetes,more anterior descending artery lesions,less incidence of UA,more incidence of MI.Blood test showed that low-density lipoprotein,uric acid and creatinine levels of heart failure group were significantly higher than those of control group.Line Logistic regression analysis showed that age,left anterior descending artery lesions,white blood cell numbers,uric acid levels were the high risk factors of heart failure after PCI.Conclusion Elder patients with anterior descending artery lesions combined with higher white blood cell numbers and uric acid levels suffered a higher risk of heart failure after PCI.

关 键 词：急性冠脉综合征 高危因素分析 PCI术后 心力衰竭 高危患者 多因素LOGISTIC回归分析 陈旧心肌梗死 手术操作时间 

分 类 号：R541.4[医药卫生—心血管疾病]