早发急性心肌梗死患者行经皮冠状动脉介入术后预后的影响因素分析  

Analysis of prognostic influence factors in patients with early-onset acute myocardial infarction after percutaneous coronary intervention

作　　者：廖家有[1] 徐龙霞 凌嘉源[1] 刘心强[1] LIAO Jiayou;XU Longxia;LING Jiayuan;LIU Xinqiang(The First Affiliated Hospital of Gannan Medical College,Vasculocardiology Department,Ganzhou 341400 Jiangxi,China;The First Affiliated Hospital of Gannan Medical College,Anesthesiology Department,Ganzhou 341400 Jiangxi,China)

机构地区：[1]赣南医学院第一附属医院心血管内科,江西赣州341400 [2]赣南医学院第一附属医院麻醉科,江西赣州341400

出　　处：《中国民康医学》2023年第15期1-4,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析早发急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)后预后的影响因素。方法:回顾性分析2016年6月至2021年5月该院心血管内科收治的95例早发AMI患者的临床资料,患者均采用急诊PCI治疗,随访6个月,统计预后不良发生情况,比较不同预后患者的临床资料,并对AMI患者PCI术后预后相关因素进行Logistic多因素回归分析。结果:95例早发AMI患者中,PCI后预后不良发生率为28.42%(27/95)。预后不良组中多支血管病变、有吸烟史、合并高尿酸血症、心肌肌钙蛋白Ⅰ(cTnⅠ)水平>1.5μg/L、植入金属裸支架、首诊心率>76次/min、非ST段抬高型心肌梗死(NSTEMI)患者占比高于预后良好组,差异均有统计学意义(P<0.05);Logistic多因素回归分析发现,多支血管病变、有吸烟史、合并高尿酸血症、cTnⅠ水平>1.5μg/L、支架类型为金属裸支架、首诊心率>76次/min、NSTEMI均是导致AMI患者PCI术后预后不良的独立危险因素(OR>1,P<0.05)。结论:多支血管病变、有吸烟史、合并高尿酸血症、cTnⅠ水平>1.5μg/L、金属裸支架、首诊心率>76次/min、NSTEMI均是导致AMI患者PCI术后预后不良的独立危险因素,临床需采取针对性干预措施,以改善患者预后。Objective:To analyze prognostic influencing factors in patients with early-onset acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:The clinical data of 95 patients with early-onset AMI admitted to this hospital from June 2016 to May 2021 were retrospectively analyzed.All patients were treated with emergency PCI.These patients were followed up for 6 months.The incidence of poor prognosis was statistically analyzed.The clinical data of the patients with different prognosis were compared.Logistic multivariate regression analysis was performed on the prognostic influencing factors of PCI.Results:Among the 95 patients with early-onset AMI,the incidence of poor prognosis after PCI was 28.42%(27/95).The proportions of multivessel disease,smoking history,combined hyperuricemia,cardiac troponin I(cTn I)level>1.5μg/L,implantation of bare metal stents,initial heart rate>76 beats/min,and non-ST segment elevation myocardial infarction(NSTEMI)in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Logistic multivariate regression analysis found that multivessel diseases,smoking history,combined hyperuricemia,cTn I level>1.5μg/L,metal bare stent type,initial heart rate>76 beats/min,and NSTEMI were all independent risk factors for the poor prognosis after PCI(OR>1,P<0.05).Conclusions:Multivessel diseases,smoking history,combined hyperuricemia,cTn I level>1.5μg/L,metal bare stent type,initial heart rate>76 beats/min,and NSTEMI are the independent risk factors for the poor prognosis after PCI.Targeted intervention measures should be taken in clinical practice to improve the prognosis.

关 键 词：早发心肌梗死 临床特征 经皮冠状动脉介入术 预后 多支血管病变 吸烟史 影响因素 

分 类 号：R542.2[医药卫生—心血管疾病]