摘要
目的探讨休克指数(SI)对行经皮冠状动脉介入治疗的急性心肌梗死患者长期预后的预测价值。方法连续入选行经皮冠状动脉介入治疗的急性心肌梗死患者1 864例。基于受试者工作特征曲线确定的最佳界值将患者分为低SI组(n=564,SI≤0.51)和高SI组(n=1 300,SI>0.51)。通过COX回归分析研究SI对此类患者长期预后的影响。结果高SI组入院心功能Ⅲ/Ⅳ级患者比例高于低SI组。术后随访显示,高SI组与低SI组比较,全因死亡率及心源性死亡率更高。多因素COX回归分析显示,SI是行经皮冠状动脉介入治疗的急性心肌梗死患者全因死亡及心源性死亡的独立预测因子。结论 SI是预测行经皮冠状动脉介入治疗的急性心肌梗死患者长期预后的一项简单有效的临床指标,SI>0.51的患者长期预后较差。
Objective To investigate the predictive value of shock index（SI） in the long-term prognosis of patients with acute myocardial infarction（AMI） undergoing percutaneous coronary intervention（PCI）. Methods A total of 1 864 patients suffering from AMI treated by PCI was enrolled in the study. On the basis of the optimal threshold of the ROC,the patients were divided into low SI group（n = 564,SI≤0.51） and high SI group（n = 1 300,SI0.51）. The predictive value of SI in long-term prognosis of AMI patients undergoing PCI was then analyzed by COX regression analysis. Results The heart function classification grades Ⅲ/Ⅳ in the SI 0.51 group were significantly higher than in the SI ≤ 0.51 group. Patients in the high SI group had a higher incidence of all-cause mortality and cardiac mortality during follow-up. Multivariate COX analysis indicated that SI was an independent risk predictor for all-cause mortality and cardiac mortality in such patients. Conclusion SI is a simple and effective clinical index for predicting the long-term prognosis of patients with AMI undergoing PCI with a significant increase in mortality and poor long term prognosis,when the SI is over 0.51.
作者
武佳科
田春阳
何东旭
宋佳
于彤彤
孙志军
孙兆青
WU Jiake;TIAN Chunyang;HE Dongxu;SONG Jia;YU Tongtong;SUN Zhijun;SUN Zhaoqing(Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang 110022, China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2018年第6期522-526,共5页
Journal of China Medical University
基金
辽宁省社会发展攻关计划(2011225020)
关键词
急性心肌梗死
经皮冠状动脉介入治疗
休克指数
预后
主要心血管不良事件
acute myocardial infarction
percutaneous coronary intervention
shock index
prognosis
major adverse cardiovascular events
