PCI术后心脏超声血流动力学参数对急性心肌梗死患者主要心血管不良事件的预测价值分析  

Predictive Value Analysis of Cardiac Ultrasound Hemodynamic Parameters for Major Cardiovascular Adverse Events in Patients with Acute Myocardial Infarction after PCI

作　　者：宋晔 邓岚岚 王磊[1] 吴继京 SONG Ye;DENG Lanlan;WANG Lei;WU Jijing(Beijing Fengtai Hospital,Beijing 100071,China)

机构地区：[1]北京丰台医院,北京100071 [2]北京市丰台区丰台社区卫生服务中心

出　　处：《中外医学研究》2025年第8期64-68,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析经皮冠状动脉介入(PCI)术后心脏超声血流动力学参数对急性心肌梗死(AMI)患者主要心血管不良事件(MACE)的预测价值。方法:选取2018年10月—2022年10月于北京丰台医院住院的110例接受PCI的AMI患者作为研究对象,根据术后6个月是否发生MACE进行分组,发生MACE的31例患者设为发生组,未发生MACE的79例患者设为未发生组。比较两组心脏超声血流动力学参数[心排血量(CO)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)],logistic回归分析MACE的影响因素,受试者工作(ROC)曲线分析心脏超声血流动力学参数对MACE的预测效能。结果:发生组LVESV、LVEDV均较未发生组更高,CO、LVEF均较未发生组更低,差异有统计学意义(P<0.05);发生组肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)与未发生组比较,差异有统计学意义(P<0.05);logistic回归分析结果显示:LVESV、LVEDV、CO、LVEF、CK-MB、cTnI是MACE发生的影响因素(P<0.05);LVESV、LVEDV、CO、LVEF联合预测MACE曲线下面积(AUC)均明显大于单一指标,差异有统计学意义(P<0.05)。结论:AMI患者PCI术后发生MACE会引起LVESV、LVEDV增高,CO、LVEF降低,LVESV、LVEDV、CO、LVEF、CK-MB、cTnI是MACE发生的影响因素,LVESV、LVEDV、CO、LVEF联合检测可提高MACE的预测效能。Objective:To analyze the predictive value of cardiac ultrasound hemodynamic parameters for major cardiovascular adverse events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Method:A total of 110 AMI patients who underwent PCI in Beijing Fengtai Hospital from October 2018 to October 2022 were selected as the research objects,according to whether MACE occurred 6 months after operation,31 patients with MACE were set as the occurrence group,and 79 patients without MACE were set as the non-occurrence group.The cardiac ultrasound hemodynamic parameters[cardiac output(CO),left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),and left ventricular ejection fraction(LVEF)]in two groups were compared,logistic regression was used to analyze the influencing factors of MACE,and receiver operating(ROC)curve was used to analyze the predictive efficacy of cardiac ultrasound hemodynamic parameters on MACE.Result:The LVESV and LVEDV in the occurrence group were higher than those in the non-occurrence group,and CO and LVEF were lower than those in the non-occurrence group,the differences were statistically significant(P<0.05);there were significant differences in the creatine kinase isoenzyme(CK-MB)and troponin I(cTnI)between the occurrence group and the non-occurrence group(P<0.05).logistic regression analysis showed that LVESV,LVEDV,CO,LVEF,CK-MB and cTnI were the influencing factors of MACE(P<0.05);the area under the curve(AUC)of LVESV,LVEDV,CO and LVEF combined prediction of MACE was significantly larger than those of single indexes,and the differences was statistically significant(P<0.05).Conclusion:The occurrence of MACE in patients with AMI after PCI will cause the increase of LVESV and LVEDV,and the decrease of CO and LVEF,LVESV,LVEDV,CO,LVEF,CK-MB and cTnI are the influencing factors of MACE,the combined detection of LVESV,LVEDV,CO and LVEF can improve the predictive efficacy of MACE.

关 键 词：经皮冠状动脉介入术 心脏超声血流动力学参数 急性心肌梗死 主要心血管不良事件 

分 类 号：R54[医药卫生—心血管疾病]