摘要
目的探讨不同部位ST 段抬高型急性心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者并发心脏破裂的临床特征及预后。方法选择2012年2月至2017年2月间邯郸市第一医院收治的确诊为急性STEMI 并发心脏破裂的患者83 例作为研究对象。根据患者发生心肌梗死的部位分为前壁梗死组、下壁梗死组、右心室梗死组及多室壁梗死组4组,对存活患者进行30 d随访,对4组患者的临床资料及预后进行统计学分析。结果急性心肌梗死并发心脏破裂患者中前壁梗死组52例、下壁梗死组14例、右心室梗死组10例、多室壁梗死组7例。各组患者的年龄、性别、体质量指数、血红蛋白及破裂部位比较,差异有统计学意义(P<0.05);各组患者住院治疗期间β受体阻断药的使用率比较,差异有统计学意义(P<0.05);各组患者的住院不良事件及病死率均很高,院内总体病死率60.24%(50/83),各组心肌梗死至心脏破裂时间0~3 d;存活患者出院随访30 d,总体生存率57.58%(19/33)。结论不同部位急性心肌梗死患者并发心脏破裂患者临床基线特征存在一定差异,患者院内病死率高,预后极差。应针对患者特点,采取适当的临床措施积极治疗。
Objectives To investigate the clinical features and prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)complicated with cardiac rupture. Methods A total of 83 patients with acute STEMI who were admitted to The First People′s Hospital of Handan between February 2012 and February 2017 were selected as the study subjects. According to the site of myocardial infarction,the patients were divided into four groups:anterior wall infarction group,inferior wall infarction group,right ventricular infarction group and multi-chamber infarction group. Survival patients were followed up for 30 days. Clinical data of the four groups were obtained. The prognosis was statistically analyzed. Results Among the 83 patients with acute STEMI complicated with cardiac rupture,there were 52 cases of anterior wall infarction,14 cases of inferior wall infarction group,10 cases of right ventricular infarction group,and 7 cases of multiple wall infarction group. The differences in age,sex,body mass index,hemoglobin,and rupture sites were statistically significant among the 4 groups(P<0.05);there was a significant difference in the use of beta-blockers during hospitalization among the 4 groups(P<0.05). Adverse events during hospitalization and mortality rates were high in all the 4 groups. The overall in-hospital mortality rate was 60.24%(50/83). The duration from myocardial infarction to cardiac rupture was 0 to 3 days in each subgroup. After 30 days of follow-up,the overall survival rate was 57.58%(19/33). Conclusions There are some differences of clinical baseline characteristics in patients with acute STEMI complicated with cardiac rupture with different parts of the infarction sites. The patients have high in- hospital mortality and poor prognosis. Patients should be taken appropriate clinical measures and active treatment.
作者
王学智
谷世奎
WANG Xue-zhi;GU Shi-kui(No.2 Department of Cardiology,The First People′s Hospital of Handan,Handan,Hebei 056004,China)
出处
《岭南心血管病杂志》
2019年第3期272-276,283,共6页
South China Journal of Cardiovascular Diseases
关键词
心肌梗死
心脏破裂
临床特征
预后
myocardial infarction
cardiac rupture
clinical characteristics
prognosis
