摘要
目的研究急性心肌梗死患者入院早期血细胞比容(Hematocrit,HCT)水平与经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后心力衰竭(heart failure,HF)发生的相关性。方法收集2010年1月—2010年12月入住的872例行急诊PCI术的急性心肌梗死患者。按照入院时测定的HCT水平分成3组:贫血组229例(其中男性HCT<39%或女性HCT<36%),正常组600例和红细胞增多组43例(其中男性HCT>47%或女性HCT>46%),随访65个月,比较各组患者随访期间发生主要心血管事件情况。结果 3组患者入院时年龄、LDL-C、TC、TG、性别、吸烟史、入院心电图ST段抬高型和透析史方面差异有统计学意义(P<0.05)。术后65个月,3组间HF发生率存在显著性差异(P<0.01),而其中贫血组与正常组存在显著性差异(P<0.01)。进一步行二分类多因素Logistic回归分析,校正了年龄、吸烟史、高脂血症病史因素后,结果显示HCT是急性心肌梗死患者PCI术后65个月发生HF的独立预测因素(r=4.466,P<0.05)。结论入院低HCT水平患者心衰发生率较高,可能是急性心肌梗死患者PCI术后5年心血管事件发生的预测因素。
Objective To explore the correlation between the level of hematocrit （HCT） of the patients with acute myocardial infarction （AMI） shortly after admission and the heart failure （HF） after percutaneous coronary intervention （PCI）. Methods The clinical data of 872 patients with AMI undergoing emergent PCI hospitalized during the period from Jan., 2010 to Dec., 2010 were collected and 872 patients were divided into 3 groups according to the level of HCT detected at admission： anemia group （n =229, HCT 〈 39% for men and HCT 〈 36% for women）, normal group （n=600） and erythrocytosis group （n = 43, HCT 〉 47 % for men and HCT 〉 46 % for women）; follow-up lasted for 65 months; a comparative study was made to the occurrence of cardiovascular events during follow-up among the groups. Results The comparison of the general clinical data at admission showed that there existed a statistical difference in age, low-density lipoprotein （LDL-C）, total chol- esterol （TC）, triglycerides （TG）, sex, smoking history, ST-elevation and dialysis history （P〈0.05）; the occurrence of heart failure 65 months after operation was of obvious difference among the 3 groups （P〈0.01）, the occurrence in anemia group was greatly different from that in normal group （P 〈 0.01）; binary logistic regression analysis was made with the adjustment of age, smoking history and hyperlipidaemia and the result indicated that HCT was the independent predictor of HF occurrence 65 months after PCI in patients with AMI （r=4.466, P〈0.05）. Conclusions HF occurrence in patients with low level of HCT after admission is high, which may be the predictor of the occurrence of cardiovascular events in patients with AMI 5 vears after PCI.
作者
汪莉
汪海娅
Wang Li Wang Haiya(Department of Geriatrics, Renji Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, 200001, P. R. China)
出处
《老年医学与保健》
CAS
2017年第3期162-164,197,共4页
Geriatrics & Health Care
关键词
血细胞比容
心肌梗死
经皮冠状动脉介入治疗
心力衰竭
hematocrit（HCT）
myocardial infarction
percutaneous coronary intervention（PCI）
heart failure（HF）
