摘要
目的：分析行急诊经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者的影响因素。方法：回顾性分析2005年1月至2015年1月因AMI于我院行急诊PCI诊治的656例患者的临床资料。对入选患者从发病相关因素、冠脉病变、开通血管时间等方面比较AMI的近期预后情况（心衰、心源性休克、心律失常发生率及死亡率）。结果：男性的平均发病年龄显著小于女性（P〈0.05）。冬春季AMI发病率显著高于夏秋季（χ2=6.244,P=0.012）。按照是否合并高血压、糖尿病、血脂异常和吸烟,患者被分为相应的疾病组和正常组,仅糖尿病组的心源性休克（37.78%比29.62%）和心律失常发生率（47.78%比38.24%）显著高于非糖尿病组,血脂异常组的死亡率显著低于血脂正常组（0.73%比3.69%）,P〈0.05或〈0.01,其余发生率在正常组和疾病组间均无显著差异（P均〉0.05）。不同冠脉病变组间比较,RCA组的心律失常发生率显著高于左前降支（LAD）组、LCX组和多支病变组（56.36%比31.55%,37.50%,34.38%）,左主干组的死亡率显著高于LAD组、RCA组和LCX组（25.00%比1.79%,0.91%,0%）,P〈0.05或〈0.01。不同血管开通时间组间比较,10～12h组心衰发生率显著高于0～3h组、4～6h组和7～9h组（79.46%比61.70%,66.81%,64.78%）,心律失常发生率显著低于0～3h组、4～6h组和7～9h组（32.14%比55.32%,43.81%,44.65%）,心源性休克发生率（35.27%比21.28%）显著高于0~3h组（P〈0.05或〈0.01）。结论：发病年龄、季节、糖尿病、冠脉病变、开通血管时间是影响AMI近期预后的危险因素。
Objective： To analyze influence factors in patients with acute myocardial infarction （AMI） undergoing e- mergency percutaneous coronary intervention （PCI）. Methods： Clinical data of 656 patients, who received emer- gency PCI because of AMI in our hospital from Jan 2005 to Jan 2015, were retrospectively analyzed. Short- term prognosis, including incidence rates of heart failure （HF）, cardiogenic shock （CS）, arrhythmias and mortality, were compared and analyzed among these patients from onset related factors, coronary disease and vascular reope- ning time etc. Results： Mean onset age of men was significantly younger than that of women （PG0. 05）. Incidence rate of AMI in winter and spring was significantly higher than those in summer and autumn （~z = 6. 244, P = 0. 012）. According to complicated with hypertension, DM, dyslipidemia and smoking or not, patients were divided into corresponding disease group and normal group; only incidence rates of CS （37.78% vs. 29.62%） and arrhyth- mia （47.78% vs. 38. 24%） in DM group were significantly higher than those of non- DM group, mortality rate of dyslipidemia group was significantly lower than that of normal blood lipid group （0. 73% vs. 3. 69%）, P〈0. 05 or〈0.01, there were no significant difference in incidence rates of other events between normal group and disease group （P〉0. 05 all）. Incidence rate of arrhythmia in RCA group was significantly higher than those of LAD group, LCX group and multi- vessel group （56. 36% vs. 31.55%, 37.50%, 34.38%）, mortality of LM group was signifi- cantly higher than those of LAD group, RCA group and LCX group （25.00% vs. 1.79%, 0.91%, 0%）, P〈0.05 or 〈0.01. Incidence rate of HF in 10～12h group was significantly higher than those of 0～3h, 4～6h and 7～9h group （79.46% vs. 61.70%, 66. 81%, 64.78%）, incidence rate of arrhythmia was significantly lower than those of 0～3h, 4～6h and 7～9h group （32.14% vs. 55.32%, 43.81%, 44. 65%）, and incidence rate of CS was sign
出处
《心血管康复医学杂志》
CAS
2016年第1期58-61,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌梗死
心力衰竭
休克
心源性
心律失常
心性
Myocardial infarction Heart failure
Shock, cardiogenic Arrhythmias, cardiac
