急性心肌梗死患者血清肌酐水平与疗效及预后的关系研究  

Effect of High Serum Creatinine Level on Clinical Therapeutic Effect and Prognosis in Patients with Acute Myocardial Infarction

作　　者：黄国梁[1] 罗晓斌[1] 袁益清[1] HUANG Guo-liang;LUO Xiao-bin;YUAN Yi-qing(Emergency Department of Jieyang People's Hospital,Jieyang,Guangdong,522000)

机构地区：[1]广东省揭阳市人民医院急诊科,522000

出　　处：《岭南急诊医学杂志》2023年第2期114-116,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨急性心肌梗死患者的血清肌酐水平与其临床疗效和预后的关系。方法:收集2020年1月-2022年6月在本院住院心血管内科住院治疗的患者70例,均确诊为急性心肌梗死,以血清肌酐水平≥116μmol/L分为观察组,共35例(男性18例、女性17例),血清肌酐水平<116μmol/L为对照组,共35例(男性17例、女性18例),在治疗后即刻、第3天和第7天比较两组的LVEF,治疗后180天比较两组的超敏C-反应蛋白、白细胞、中性粒细胞百分比、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、肌酸激酶和肌酸激酶同工酶水平,并记录各时期心房颤动、心力衰竭、心源性休克等心脏事件发生情况,以及各时期的死亡率。结果:治疗后即刻、第3天和第7天观察组患者LVEF均明显低于对照组(P<0.05);治疗180天后,观察组的超敏C-反应蛋白、总胆固醇、白细胞、三酰甘油、肌酸激酶、中性粒细胞百分比和肌酸激酶同工酶水平均明显高于对照组(P<0.05);观察组心房颤动、心力衰竭、心源性休克等心脏事件的发生率及7天死亡率均明显高于对照组(P<0.05)。结论:高血清肌酐水平是影响急性心肌梗死患者临床疗效和预后的独立危险因素。Objective:To investigate the effect of high serum creatinine level on clinical efficacy and prognosis of acute myocardial infarction(AMI).Methods:Seventy patients with acute myocardial infarction hospitalized in cardiovas⁃cular medicine department of Jieyang People's hospital from January 2020 to June 2022 were included and divided into two groups according to serum creatinine level.35 patients with serum creatinine level(≥116μmol/L)were inthe obser⁃vation group while35 patients with serum creatinine level(<116μmol/L)were in the control group.LVEF was compared between the two groups immediately after treatment and on days 3 and 7.Ventricular ejection fraction was compared be⁃tween the two groups 180 days after treatment.The levels of hypersensitive C⁃reactive protein,white blood cells,per⁃centage of neutrophils,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,creatine kinase and creatine kinase isoenzymes were compared.The occurrence and mortality of cardiac events such as atrial fibrillation,heart failure and cardiogenic shock were recorded.Results:The left ventricular ejection fraction in the observation group was significantly lower than that in the control group at the point of immediately after treatment,and on days 3 and 7(P<0.05).At the days 180 after treatment,the levels of hypersensitive C⁃reactive protein,white blood cells,percentage of neutrophils,total cholesterol,triglyceride,creatine kinase and creatine kinase isoenzymes in the observation group were significantly higher than those in the control group(P<0.05).The incidence of cardiac events such as heart failure,car⁃diogenic shock and mortality at days 90 and days 180 were significantly higher than those in the control group(P<0.05).Conclusion:High serum creatinine level is an independent risk factor affecting the clinical efficacy and prognosis of acute myocardial infarction.

关 键 词：高血清肌酐水平 急性心肌梗死 临床治疗效果 预后 影响 

分 类 号：R542.22[医药卫生—心血管疾病]