摘要
目的探讨急性心肌梗死患者行冠状动脉介入临床疗效及其预后的影响因素,以提高患者预后效果。方法选择高密市中医院2022年1月—2023年6月收治的72例急性心肌梗死患者作为研究对象行冠状动脉介入治疗,观察患者治疗效果,并基于患者预后情况,将患者分为预后良好组(n=50)与预后不良组(n=22)。对影响冠状动脉介入术(percutaneous coronary intervention,PCI)预后的相危险因素采用logistic回归分析。结果在治疗中,显效43例(59.72%),有效24例(33.34%),无效5例(6.94%),治疗有效率为93.06%,急性心肌梗死患者行冠状动脉介入治疗的效果显著。在单因素分析中,预后良好组与预后不良组在年龄、合并高血压、合并糖尿病、肌钙蛋白(cardiac troponin,cTnI)水平、术前Killip分级、术后血流分级(thrombolysis in myocardial infarction,TIMI)差异有统计学意义(P<0.05)。logistic多因素分析显示,年龄、合并高血压、合并糖尿病、cTnI水平、术前心功能分级和术后TIMI血流分级是急性心肌梗死患者行冠状动脉介入术预后效果的独立危险因素(OR=5.174、5.332、5.308、6.571、7.129、8.146,P<0.05)。结论在急性心肌梗死患者治疗中,行冠状动脉介入治疗效果显著,但预后受年龄、合并疾病(高血压、糖尿病)、术前心功能分级和术后TIMI血流分级等因素影响,应针对危险因素,切实做好预后干预治疗,提高患者的预后效果。
Objective To explore the clinical efficacy and prognostic factors of coronary intervention in patients with acute myocardial infarction,in order to improve patient prognosis.Methods A total of 72 cases of acute myocardial infarction admitted to Gaomi Traditional Chinese Medicine Hospital from January 2022 to June 2023 were selected as the study subjects for coronary intervention treatment.The treatment effect of the patients was observed,and based on their prognosis,the patients were divided into a good prognosis group(n=50)and a poor prognosis group(n=22).Logistic regression analysis was used to identify the risk factors that affect the prognosis of coronary intervention(PCI).Results In the treatment,43 cases(59.72%)showed significant improvement,24 cases(33.34%)were effective,and 5 cases(6.94%)were ineffective,with an effective treatment rate of 93.06%.Coronary intervention therapy was significantly effective in patients with acute myocardial infarction.In univariate analysis,there were significant differences between the good prognosis group and the poor prognosis group in age,hypertension,diabetes,cardiac troponin(cTnI)level,preoperative Killip grade and postoperative thrombolysis in myocardial infarction(TIMI)blood flow grade(P<0.05).In logistic multivariate analysis,age,hypertension,diabetes,cTnI level,preoperative Killip grade and postoperative TIMI blood flow grade were independent risk factors for the prognosis of patients with acute myocardial infarction undergoing coronary intervention(OR=5.174,5.332,5.308,6.571,7.129,8.146,P<0.05).Conclusion In the treatment of patients with acute myocardial infarction,the effect of coronary artery intervention is significant,but the prognosis is affected by age,concomitant diseases(hypertension,diabetes),preoperative Killip grade and postoperative TIMI blood flow grade,and other factors.It is necessary to do a good job of prognosis intervention in accordance with risk factors to improve the prognosis of patients.
作者
高志芳
李杰
温聪聪
GAO Zhifang;LI Jie;WEN Congcong(Department of Emergency,Gaomi Traditional Chinese Medicine Hospital,Gaomi Shandong 261500,China;Department of Cardiology,Gaomi Traditional Chinese Medicine Hospital,Gaomi Shandong 261500,China)
出处
《中国卫生标准管理》
2024年第13期103-107,共5页
China Health Standard Management
关键词
急性心肌梗死
冠状动脉介入
疗效
心肌功能
预后
影响因素
acute myocardial infarction
coronary artery intervention
therapeutic effect
myocardial function
prognosis
influence factor
