STEMI患者并发心包积液的影响因素分析  

Analysis of influencing factors of pericardial effusion in patients with STEMI

作　　者：张骏[1] 许燕 ZHANG Jun;XU Yan(Department of Emergency and Intensive Care,the People's Hospital of Yuyao,Zhejiang,Ningbo 315400,China;EICU,the People's Hospital of Yuyao,Zhejiang,Ningbo 315400,China)

机构地区：[1]浙江省余姚市人民医院急诊重症科,浙江余姚315400 [2]浙江省余姚市人民医院EICU,浙江余姚315400

出　　处：《中国现代医生》2022年第23期29-33,共5页China Modern Doctor

摘　　要：目的 分析急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者并发心包积液的影响因素。方法 选择浙江省余姚市人民医院2017年6月至2021年6月收治的STEMI患者445例为研究对象,按照是否存在心包积液分为心包积液组80例,无心包积液组365例。采用单因素、多因素对STEMI患者并发心包积液的影响因素进行分析。结果 单因素分析显示,两组患者在年龄、Killip功能分级≥Ⅲ级、经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后心肌梗死溶栓治疗试验(thrombolysis in myocardial infarction,TIMI)分级>2级、血清肌酸激酶同工酶(creatine kinase-MB,CK-MB)峰值、PCI术后左室射血分数(left ventricular ejection fraction,LVEF)、血栓抽吸、梗死相关血管[左前降支(left anterior descending,LAD)、右冠状动脉(right coronary artery,RCA)]、住院期间急性左心衰竭、住院期间恶性心律失常方面比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄、PCI术后TIMI分级>2级、CK-MB峰值、PCI术后LVEF、血栓抽吸治疗均是并发心包积液的独立相关因素(P<0.05)。结论 年龄、PCI术后TIMI分级>2级、CK-MB峰值、PCI术后LVEF、血栓抽吸均为STEMI患者并发心包积液的相关因素,其中年龄和CK-MB峰值呈正相关,其余因素为负相关,可为临床防治提供参考。Objective To analyze the influencing factors of pericardial effusion in patients with acute ST segment elevation myocardial infarction(STEMI). Methods A total of 445 patients with STEMI diagnosed clinically in our hospital from June 2017 to June 2021 were divided into two groups according to the presence of pericardial effusion: pericardial effusion group(n=80) and non-pericardial effusion group(n=365). The influencing factors of complicated pericardial effusion in patients were analyzed by multiple factors. Results The data of patients in the two groups were compared by single factor analysis, among which there were significant differences in age, Killip grade ≥Ⅲ, thrombolysis in myocardial infarction(TIMI) grade >2 afterpercutaneous coronary intervention(PCI), creatine kinase-MB(CK-MB) peak value, left ventricular ejection fraction(LVEF) after PCI, thrombus aspiration, infarct-related vessels left anterior descending(LAD), right coronary artery(RCA), acute left heart failure during hospitalization and malignant arrhythmia during hospitalization(P<0.05). Multivariate Logistic regression analysis showed that age, TIMI grade >2 after PCI,CK-MB peak, LVEF after PCI and thrombus aspiration were independent related factors for pericardial effusion(P<0.05). Conclusion Age, TIMI grade>2 after PCI, peak CK-MB, LVEF after PCI and thrombus aspiration are all related factors of pericardial effusion in patients with STEMI. There is a positive correlation between age and peak CK-MB, and a negative correlation between other factors, which can provide reference for clinical prevention and treatment.

关 键 词：急性ST段抬高型心肌梗死 心包积液 经皮冠状动脉介入术 CK-MB峰值 左室射血分数 

分 类 号：R749.3[医药卫生—神经病学与精神病学]