摘要
目的分析行急诊经皮冠状动脉介入(PCI)术后老年急性心肌梗死(AMI)患者住院期间心血管事件危险因素及预控措施。方法将2021.03-2023.10河南省胸科医院接收的116例老年AMI行急诊PCI患者的住院病历资料信息进行回顾性研究,按照住院期间心血管事件的发生情况,将其分为两组。术后对患者进行护理干预。分析两组临床资料,将临床资料统计学有差异的实施多因素Logistic回归分析,得出影响老年AMI患者急诊PCI术后住院期间心血管事件发生的因素,并对每项因素进行预控措施。结果116例老年AMI行急诊PCI患者中,住院期间37例(31.90%)发生心血管事件,79例(68.10%)未发生心血管事件。单因素结果显示,心血管事件发生组年龄≥68岁、既往有吸烟史、合并基础疾病(高脂血症、糖尿病、高血压)、超敏-C反应蛋白(hs-CRP)≥23.91 mg/L、美国纽约心脏病协会(NYHA)心功能分级≥Ⅱ级、肌钙蛋白Ⅰ(cTnⅠ)≥7.24μg/L、低密度脂蛋白胆固醇(LDL-C)≥2.83 mmol/L患者占比均高于未发生组;术前强化他汀治疗患者占比低于未发生组(P<0.05)。多因素数据中得出,老年AMI行急诊PCI患者发生心血管事件的影响因素是年龄≥68岁、合并基础疾病、hs-CRP≥23.91 mg/L、NYHA≥Ⅱ级、LDL-C≥2.83 mmol/L、cTnⅠ≥7.24μg/L;术前强化他汀治疗为保护因素(P<0.05)。结论年龄≥68岁、合并基础疾病、hs-CRP≥23.91 mg/L、NYHA心功能分级≥Ⅱ级、cTnⅠ≥7.24μg/L、LDL-C≥2.83 mmol/L是老年AMI行急诊PCI患者住院期间发生心血管事件的影响因素;保护因素为术前强化他汀治疗,临床可对有以上临床特征的患者进行密切关注,并开展实施针对性预控措施,以降低住院期间发生心血管事件风险。
Objective Analyze the risk factors and pre control measures for cardiovascular events during hospitalization in elderly patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI).Methods A retrospective study was conducted on the inpatient medical records of 116 elderly patients with AMI who underwent emergency PCI received from Henan Provinaial Chest Hospital from March,2021 to October,2023.According to the occurrence of cardiovascular events during hospitalization,the patients were divided into two groups.Nursing intervention for patients after operation.Clinical data of the two groups were analyzed,and multivariate Logistic regression analysis was carried out based on statistical differences in clinical data.Factors affecting the occurrence of cardiovascular events in elderly AMI patients during hospitalization after emergency PCI were obtained,and pre-control measures were taken for each factor.Results Among 116 elderly AMI patients undergoing emergency PCI,37 cases(31.90%)experienced cardiovascular events during hospitalization,and 79 cases(68.10%)did not experience cardiovascular events.The univariate results showed that the proportion of patients in the cardiovascular event group with age≥68 years,smoking history,combined basic diseases(hyperlipidemia,diabetes,hypertension),high-sensitivity C-reactive protein(hs CRP)≥23.91 mg/L,NYHA cardiac function grade≥II,troponin I(cTn I)≥7.24μg/L,and low-density lipoprotein cholesterol(LDL-C)≥2.83 mmol/L were higher than those in the non event group;The proportion of patients receiving preoperative intensified statin treatment was lower than that of the non occurring group(P<0.05).According to multivariate data,the influencing factors for cardiovascular events in elderly AMI patients undergoing emergency PCI are age≥68 years old,comorbidities with underlying diseases,hs CRP≥23.91 mg/L,NYHA≥grade II,LDL-C≥2.83 mmol/L,and cTnⅠ≥7.24μg/L;Preoperative intensified statin therapy was a protective factor(P<0.0
作者
刘丽杰
齐林
王焕东
LIU Li-jie;QI Lin;WANG Huan-dong(Six Disease Areas in the Department of Cardiovascular Medicine,Henan Provincial Chest Hospital,Zhengzhou 450000,Henan Province,China;Emergency Department,Henan Provincial Chest Hospital,Zhengzhou 450000,Henan Province,China)
出处
《罕少疾病杂志》
2024年第7期59-62,共4页
Journal of Rare and Uncommon Diseases
基金
河南省医学科技攻关计划项目(LHGJ20190730)。
关键词
急诊经皮冠状动脉介入术
急性心肌梗死
心血管事件
不良因素
Emergency Percutaneous Coronary Intervention
Acute Myocardial Infarction
Cardiovascular Events
Adverse Factors
