急性ST段抬高型心肌梗死患者溶栓成功后左室射血分数下降的相关因素研究  

Study on the Relationship between the Decrease of Left Ventricular Ejection Fraction after Successful Thrombolysis in Patients with Acute ST Segment Elevation Myocardial Infarction

作　　者：陆珏秀 刘先霞[2] 闫霖 

机构地区：[1]海南医学院第二临床学院,海南 海口 [2]海南医学院第二附属医院心血管内科,海南 海口

出　　处：《临床医学进展》2023年第2期1332-1340,共9页Advances in Clinical Medicine

摘　　要：目的:研究急性ST段抬高型心肌梗死患者溶栓成功后左室射血分数下降的影响因素。方法:选取2020年1月至2022年8月海南医学院第二附属医院心血管内科收治的急性ST段抬高型心肌梗死且溶栓成功的患者147例为研究对象,将患者分为左心室收缩功能正常组及下降组;通过比较组间基线特征差异,使用Spearman双侧相关分析及二元Logistic回归分析差异具有统计学意义的变量。结果:Spearman双侧相关分析结果表明前壁心梗(r = 0.220, P < 0.01)、左前降支病变(r = 0.204, P < 0.05)、心室节段性室壁运动异常(r = 0.389, P < 0.01)与LVEF均呈显著相关。二元Logistic回归分析结果表明心室节段性室壁运动异常与左室射血分数独立相关(P < 0.01)。结论:前壁心梗、前降支病变、心室节段性室壁运动异常与LVEF均呈显著相关;心室节段性室壁运动异常是急性ST段抬高型心肌梗死患者溶栓成功后左室射血分数下降的独立预测因子。Objective: To investigate the influencing factors of left ventricular ejection fraction decrease in pa-tients with acute ST-segment elevation myocardial infarction after successful thrombolysis. Meth-ods: A total of 147 patients with acute ST-segment elevation myocardial infarction with successful thrombolysis admitted to the Department of Cardiovascular Medicine of the Second Affiliated Hos-pital of Hainan Medical University from January 2020 to August 2022 were selected as the study subjects. The patients were divided into normal left ventricular systolic function group and de-creased group (LVEF male < 52%, female < 53%). The differences in baseline characteristics be-tween groups were compared, Spearman bilateral correlation analysis and binary Logistic regres-sion analysis were used to analyze the variables with statistical significance (P < 0.05). Results: Spearman bilateral correlation analysis showed that anterior wall myocardial infarction (r = 0.220, P < 0.01), left anterior descending branch lesion (r = 0.204, P < 0.05), ventricular segmental wall motion (r = 0.389, P < 0.01) were significantly correlated with LVEF. Binary Logistic regression analysis showed that ventricular segmental wall motion abnormalities were independently corre-lated with left ventricular ejection fraction (P < 0.01). Conclusion: There was significant correlation between anterior wall myocardial infarction, anterior descending branch myocardial infarction and ventricular segmental wall motion and LVEF. Ventricular segmental wall motion abnormalities are independent predictors of left ventricular ejection fraction decrease in patients with acute ST-segment elevation myocardial infarction after successful thrombolysis.

关 键 词：急性ST段抬高型心肌梗死 溶栓 左室射血分数 相关性 

分 类 号：R54[医药卫生—心血管疾病]