心力衰竭和贫血史是急性ST段抬高型心肌梗死患者直接再灌注后Killip≥Ⅱ级的危险因素  

History of heart failure and anemia are risk factors for Killip≥gradeⅡin patients with acute ST-segment elevation myocardial infarction after direct re-perfusion

作　　者：潘碧云 陈仕银[1] 温达 王燕英 PAN Bi-yun;CHEN Shi-yin;WEN Da;WANG Yan-ying(General Practice Department of Haikou People's Hospital,Hainan Haikou 570208,China)

机构地区：[1]海口市人民医院全科医学科,海南海口570208

出　　处：《内科急危重症杂志》2021年第5期389-392,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨急性ST段抬高型心肌梗死(STEMI)患者直接再灌注后Killip≥Ⅱ级的危险因素。方法:选取2010年1月至2014年4月因STEMI入住海口市人民医院心脏重症监护病房的患者,收集其临床资料进行Logistic回归分析以确定Killip≥Ⅱ级的独立影响因素。结果:共纳入1111例患者,其中991例(89.2%)行经皮冠状动脉介入术(PCI),120例(10.8%)接受溶栓治疗。共有230例(20.7%)患者Killip≥Ⅱ级。多因素Logistic回归分析结果提示:既往有慢性心力衰竭病史[OR值(95%CI):0.600(0.402~0.895),P=0.012]、贫血[OR值(95%CI):0.372(0.206~0.671),P=0.001]是STEMI患者直接再灌注后Killip≥Ⅱ级的独立危险因素。结论:既往有心力衰竭和贫血史的STEMI患者直接再灌注后发生心功能衰竭的风险较高,住院期间需严密监测心功能及贫血指标。Objective:To investigate the risk factors for Killip≥gradeⅡafter the direct re-perfusion in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:Patients admitted to the Cardiac Intensive Care Unit of Haikou People's Hospital for STEMI from January 2010 to April 2014 were selected and their clinical data were collected for logistic regression analysis to determine the independent impact factors of Killip≥gradeⅡ.Results:A total of 1111 patients were enrolled,of which 991 cases(89.2%)received percutaneous coronary intervention(PCI)and 120 cases(10.8%)received thrombolytic therapy.There were 230 cases of Killip≥gradeⅡ(20.7%).The results of multivariate logistic regression analysis suggested that for STEMI patients after the direct re-perfusion,a previous history of chronic heart failure[OR(95%CI):0.600(0.402-0.895),P=0.012]and anemia[OR(95%CI):0.372(0.206-0.671),P=0.001]were the independent risk factor for Killip≥gradeⅡ.Conclusion:STEMI patients with a history of previous heart failure and anemia have a higher risk of cardiac failure after a direct re-perfusion and need to be closely monitored for cardiac function and anemia indicators during hospitalization.

关 键 词：ST段抬高型心肌梗死 KILLIP分级 经皮冠状动脉介入术 危险因素 

分 类 号：R542.2.2[医药卫生—心血管疾病]