摘要
目的:分析急性心肌梗塞(AMI)患者再灌注治疗后ST段回落(STR)的影响因素。方法:收集114例溶栓和71例急诊经皮冠状动脉介入(PCI)治疗的AMI患者,按溶栓或PCI治疗后90min心电图单导联STR分别分为STR<50%和STR≥50%组,对临床资料中多个变量进行单因素分析和Logistic回归分析。结果:单因素分析显示,与STR<50%患者相比,PCI组STR≥50%患者入院时血糖(Glu)(P=0.016)和白细胞(WBC)(P=0.011)较低,单支冠脉血管病变者较多(P=0.023),溶栓组STR≥50%患者Glu(P=0.002)、WBC(P=0.036)和killip心功能分级(P=0.012)较低,发病到治疗的时间更短(P=0.016),有高血压病史者(P=0.033)和前壁梗塞者(P=0.011)较少。Logistic回归分析结果PCI组最终进入方程的变量为入院时Glu(B=-0.299,P=0.021)和WBC(B=-0.201,P=0.026),溶栓组进入方程的变量有高血压病史(B=-0.978,P=0.027)、GIu(B=-0.252,P=0.003)和治疗前时间(B=-0.004,P=0.018)。结论:入院时血糖水平为AMI患者PCI或溶栓治疗后ST段回落独立的影响因素,WBC是PCI患者ST段回落的另一影响因素,高血压病史和治疗前时间则是溶栓治疗患者ST段回落的另外两个影响因素。
Objective： To analyze the risk factors of ST-segment resolution （STR） after reperfusion therapy in patients with acute myocardial infarction （AMI）. Methods： The 185 AMI patients undergoing thrombolytic therapy （TT, n = 114） or percutaneous coronary intervention （PCI, n = 71） were retrospectively observed. Single lead STR at 90 minutes after TT or PCI was calculated. In univariate analysis, clinical data were compared between patients with STR 〈 50% and those with STR≥50%. Results： By univariate analysis, in PCI group the Glucose （Glu） （P=0.016） and WBC （P=0.011） on admission were high, while single artery disease （P=0.023） was less in patients with STR 〈 50% compared with those with STR≥50%; in thrombolytic therapy group, patients with STR〈50% had high Killip grade （P=0.012）, long time from onset to treatment （P=0.016）, high Glu （P=0.002）, high WBC （P=0.036）, more hypertensive patients （P=0.033） and more anterior infarction （P=0.011） compared with those with STR≥50%. By Logistic regression analysis, the variables in PCI group finally remained in formula were Glu （B=0.299, P=0.021） and WBC （B=-0.201, P=0.026）; in thrombolytic therapy group, the Variables remained in formula were hypertension （B=-0.978, P=0.027）, Glu （B=-0.252, P=0.003） and time from onset to treatment （B=-0.004, P=0.018）. Conclusion： Glu level on admission is an independent risk factor for STR of AMI patients after （PCI and TT） therapy. WBC is another independent risk factor for PCI patients, while hypertension and time from onset to treatment are two other independent risk factors for thrombolytic patients.
出处
《心血管康复医学杂志》
CAS
2007年第1期81-84,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌梗塞
心肌再灌注
心电描记术
Myocardial infarction
Myocardium reperfusion
Electrocardiography
