摘要
目的探讨急性心肌梗死行急诊经皮冠状动脉介入治疗(PCI)后发生射血分数保留性心力衰竭(心衰)的危险因素及预后。方法以急性心肌梗死并接受急诊PCI的542例患者为研究对象,上述患者的左心室射血分数均超过50%,根据诊断资料将其分成心衰组和非心衰组,对两组收集的临床资料进行比较,分析射血分数保留性心力衰竭的危险因素,随访12个月,统计中位生存时间,分析预后。结果心衰组患者158例(29.2%),非心衰组384例(70.8%),心衰组在年龄、女性比例、合并高血压及糖尿病比例均明显高于非心衰组(P<0.05)。心衰组患者的脑钠肽前体明显高于非心衰组,钠离子及血清前白蛋白明显低于非心衰组(P<0.05)。心衰组的冠状动脉造影资料提示近端病变百分比(58.2%)明显高于非心衰组(48.2%),多支血管病变百分比(43.1%)明显高于非心衰组(29.2%,P<0.05)。心衰组发病至血运重建时间(10.78±8.68)比非心衰组(6.91±6.32)明显升高(P<0.05)。心衰组的中位生存时间是(10.6±0.6)个月,低于非心衰组的中位生存时间(11.2±0.5)个月(P<0.05)。Logistic回归分析显示年龄、女性、高血压、多支血管病变、发病至血运重建时间为急性心肌梗死行急诊PCI后发生射血分数保留性心衰的独立危险因素(P<0.05)。结论急性心肌梗死行急诊PCI后发生射血分数保留性心衰的危险因素复杂多样,预后差。
Objective To investigate the risk factors and prognosis of heart failure with preserved ejection fraction(HFpEF)in patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI).Methods AMI patients(n=542)undergone emergency PCI were chosen as subjects,and their left ventricular ejection fraction(LVEF)was over 50%.All patients were divided,according to their diagnosis materials,into heart failure(HF)group and non-HF group.The clinical materials were compared between 2 groups,and the risk factors of HFpEF were analyzed.The patients were followed up for 12 months,and the median survival time(MST)was calculated and prognosis was analyzed.Results The age and percentages of female cases,hypertension and diabetes were significantly higher in HF group(n=158,29.2%)than those in non-HF group(n=384,70.8%,P<0.05).The level of pro-brain natriuretic peptide(proBNP)was significantly higher,and levels of sodion and serum prealbumin were significantly lower in HF group than those in non-HF group(P<0.05).The results of coronary angiogram(CAG)showed that the percentage of proximal lesions was significantly higher in HF group(58.2%)than that in non-HF group(48.2%),and percentage of multi-vessel lesions was significantly higher in HF group(43.1%)than that in non-HF group(29.2%,P<0.05).The duration from HF onset to revascularization was significantly longer in HF group(10.78±8.68)than that in non-HF group(6.91±6.32,P<0.05).MST was lower in HF group(10.6±0.6)months than that in non-HF group[(11.2±0.5)months,P<0.05].The results of Logistic regression analysis showed that age,female,hypertension,multi-vessel lesions and duration from HF onset to revascularization were independent risk factors of HFpEF in AMI patients after emergency PCI(P<0.05).Conclusion The risk factors of HFpEF are complex and diverse in AMI patients after emergency PCI,and their prognosis will be poor.
作者
王娜
左艳芳
李宗赢
王书飞
Wang Na;Zuo Yanfang;Li Zongying;Wang Shufei(Department of CCU,Central Hospital of Zhoukou City,Henan Province,Zhoukou 466000,China;不详)
出处
《中国循证心血管医学杂志》
2020年第9期1122-1124,1128,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性心肌梗死
射血分数保留性心力衰竭
危险因素
预后
Acute myocardial infarction
Heart failure with preserved ejection fraction
Risk factors
Prognosis
