摘要
目的:分析急性心肌梗死经皮冠状动脉介入治疗(PCI)术后患者认知的影响因素。方法:选取2017年2月-2019年12月在本溪市中心医院接受PCI术的急性ST段抬高型心肌梗死(ST-segment elevated myocardial infarction,STEMI)患者160例,依据认知功能电话问卷修订版(telephone interview for cognitive status-modified,TICS-m)面对面认知功能评估结果将患者分为正常认知组(n=84)、轻度认知障碍组(n=45)、中重度认知障碍组(n=31)。比较三组一般资料、病情、PCI手术情况、实验室指标、血流动力学相关指标和用药情况,分析急性心肌梗死PCI术后患者认知的影响因素。结果:三组性别、年龄、受教育年限、吸烟史、高血压比例、PCI术前Killip分级、机械通气、发病至闭塞血管开通时间、累计主动脉内球囊反搏(intra-aortic balloon pump,IABP)时间比较,差异均有统计学意义(P<0.05)。年龄、发病至闭塞血管开通时间、肌红蛋白均是急性心肌梗死PCI术后患者认知功能损害的独立危险因素(P<0.05),受教育年限、累计IABP时间是急性心肌梗死PCI术后患者认知功能的保护因素(P<0.05)。结论:急性心肌梗死PCI术后患者认知的影响因素繁杂,临床应重视相关影响因素,加强PCI术后认知随访,加强对可控因素的干预,从而降低急性心肌梗死PCI术后认知障碍风险。
Objective:To analyze the cognitive influencing factors of patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Method:A total of 160 patients with ST-segment elevated myocardial infarction(STEMI)who underwent PCI in Benxi Central Hospital from February 2017 to December 2019 were selected.According to the telephone interview for cognitive status-modified,TICS-m)face-to-face cognitive function assessment results they were divided into cognitive normal group(n=84),mild cognitive impairment group(n=45),moderate and severe cognitive impairment group(n=31).The general information,condition,PCI operation,laboratory indicators,hemodynamic related indicators and medication of the three groups were compared,and the influencing factors of cognition of patients with acute myocardial infarction after PCI were analyzed.Result:There were significant differences in gender,age,years of education,smoking history,proportion of hypertension,Killip grade before PCI,mechanical ventilation,time from onset to occlusion,cumulative time of intra aortic balloon pump(IABP)among the three groups(P<0.05).Age,time from onset to occlusion and myoglobin were independent risk factors for cognitive impairment after PCI(P<0.05),while years of education and cumulative IABP time were protective factors for cognitive impairment after PCI(P<0.05).Conclusion:Factors influencing cognition of patients with acute myocardial infarction after PCI are complicated.Clinically,attention should be paid to related influencing factors and strengthening cognitive follow-up after PCI as well as intervention of controllable factors,so as to reduce the risk of cognitive impairment in patients with acute myocardial infarction after PCI.
作者
陈忠锐
CHEN Zhongrui(Benxi Central Hospital,Liaoning Province,Benxi 117000,China)
出处
《中国医学创新》
CAS
2022年第1期10-16,共7页
Medical Innovation of China
关键词
急性心肌梗死
经皮冠状动脉介入
术后认知
Acute myocardial infarction
Percutaneous coronary intervention
Postoperative cognition
