急性心肌梗死患者PCI术后再发心肌梗死的相关因素分析  

Risk factors of recurrent myocardial infarction after PCI in patients with acute myocardial infarction

作　　者：王自豪 李素娟 宋晓光[3] 张南南 侯艳艳 Wang Zihao;Li Sujuan;Song Xiaoguang;Zhang Nannan;Hou Yanyan(Department of Cardiology,Hebi People’s Hospital,Hebi 458030,China;Quality Control Office,Hebi People’s Hospital,Hebi 458030,China;Hebi Vocational and Technical College,Hebi 458030,China)

机构地区：[1]河南省鹤壁市人民医院心血管内科,458030 [2]河南省鹤壁市人民医院质管办,458030 [3]鹤壁职业技术学院,河南省458030

出　　处：《中国实用医刊》2021年第19期58-61,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨急性心肌梗死患者经皮冠状动脉介入术(PCI)后再发心肌梗死的相关因素。方法回顾性纳入2018年1月至2019年12月于鹤壁市人民医院接受PCI治疗的急性心肌梗死患者122例,根据术后是否再发心肌梗死分为再发组(32例)和非再发组(90例)。比较两组患者的临床资料。采用单因素分析研究PCI治疗急性心肌梗死后再发心肌梗死的危险因素。采用多因素Logstics回归分析研究影响PCI治疗急性心肌梗死后再发心肌梗死的独立危险因素。结果非再发组和再发组患者的年龄、伴发高血压和高血糖、饮酒史、吸烟史、术前心功能(Killip)分级、病变支数、术前左室射血分数、梗死后心绞痛、服药依从性比较,差异有统计学意义(P<0.05)。非再发组和再发组患者的性别、伴发高血脂、心脑血管疾病家族遗传史、心率、栓塞血管分类、术后心肌梗死溶栓治疗血流分级比较差异未见统计学意义(P>0.05)。多因素Logstics回归分析结果显示,高龄、伴发高血压、术前Killip分级>Ⅰ级、多支病变、梗死后心绞痛是PCI治疗急性心肌梗死后再发心肌梗死的独立危险因素,而较好的服药依从性是PCI治疗急性心肌梗死后再发心肌梗死的保护因素(P<0.05)。结论行PCI治疗急性心肌梗死后再发心肌梗死的独立危险因素是高龄、伴发高血压、术前Killip分级>Ⅰ级、多支病变、梗死后心绞痛。Objective To investigate the risk factors of recurrent myocardial infarction in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 122 patients with acute myocardial infarction treated by PCI from January 2018 to December 2019 in Hebi People’s Hospital were included retrospectively.Patients were divided into recurrent group(32 cases)and non-recurrent group(90 cases)according to myocardial infarction recurrence.The clinical data of two groups were compared.And the risk factors of recurrent myocardial infarction after PCI were analyzed.The independent risk factors of recurrent myocardial infarction after PCI were analyzed by multivariate Logstics regression analysis.Results There were significant differences in age,combined with hypertension and hyperglycemia,drinking history,smoking history,preoperative cardiac function(Killip)grade,lesion count,preoperative left ventricular ejection fraction,post-infarction angina pectoris and medication compliance between non-recurrent group and recurrent group(P<0.05).There was no significant difference in gender,combined with hyperlipidemia,family genetic history of cardiovascular and cerebrovascular diseases,heart rate,classification of embolic vessels and thrombolysis in myocardial infarction blood flow classification after operation between non-recurrent group and recurrent group(P>0.05).The results of multivariate Logstics regression analysis showed that the old age,complicated by hypertension,preoperative Killip>grade I,multiple lesions and post-infarction angina were independent risk factors for recurrent myocardial infarction after PCI,while better medication compliance was the protective factor for recurrent myocardial infarction after PCI(P<0.05).Conclusions Advanced age,complicated by hypertension,preoperative Killip grade>Ⅰ,multiple lesions and post-infarction angina pectoris are independent risk factors of recurrent myocardial infarction after PCI.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 再发心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]