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| ST段抬高性心肌梗死合并心力衰竭患者预后及影响因素分析 |
| Prognosis and influence factors in ST-segment elevation myocardial infarction complicated with heart failure |
| 投稿时间：2015-01-12 修订日期：2015-04-15 |
| DOI：10.3969/j.issn.1000-0399.2015.05.025 |
| 中文关键词: 心力衰竭 ST段抬高性心肌梗死 预后 |
| 英文关键词: Heart failure ST-segment elevation myocardial infarction Prognosis |
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| 中文摘要: |
| 目的 分析ST段抬高性心肌梗死(STEMI)合并心力衰竭患者的预后及其影响因素。方法 选取2010年1月至2014年6月收治的STEMI合并心力衰竭患者共163例,根据其是否在院期间死亡分为存活组和死亡组。对比两组患者一般情况、血液生化指标和心电图等临床资料。同时对比存活组患者溶栓前后的血清hs-CRP、CK-MB、TNT和BNP水平。采用多变量logistic回归分析患者住院期间病死率的预测因素。 结果 死亡组的男性、年龄>65岁、前壁心肌梗死(MI)、高血压、高血脂、饮酒、糖尿病、Killip 分级≥II级比率显著高于存活组,差异有统计学意义(P<0.05);死亡组的白细胞、血肌酐、肌酸激酶同功酶(CK-MB)、三硝基甲苯(TNT)、超敏C反应蛋白(hs-CRP)、甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、脑尿钠肽(BNP)均显著高于存活组,而HDL-C显著低于存活组(P<0.01);存活组患者溶栓后血清hs-CRP、CK-MB、TNT和BNP显著低于溶栓前,(P<0.05)。死亡组的溶栓成功率显著低于存活组,且差异有统计学意义(P<0.01)。 结论 高龄、血肌酐和hs-CRP水平升高、前壁MI、BNP升高、LDL-C水平升高、HDL-C水平降低、溶栓不通、在院期间发生心源性休克和Killip分级≥Ⅱ级因素影响急性心肌梗死合并心力衰竭患者的预后。 |
| 英文摘要: |
| Objective To analyze the prognosis and influence factors in patients with ST-segment elevation myocardial infarction(STEMI) complicated with heart failure. Methods A total of 163 cases of STEMI complicated with heart failure from January 2010 to June 2014 admitted to our department were retrospectively selected, according to whether they died during the hospital; they were divided into survival group and death group. The general condition, blood biochemical parameters and ECG etc were compared in the two groups of patients. logistic regression analysis was used to determine multivariate predictors of mortality in hospitalized patients. Results Men, age> 65 years, anterior MI, high blood pressure, hyperlipidemia, alcohol consumption, diabetes, Killip classification ≥II level ratio in the death group were significantly higher than those in the survival group (P<0.05). WBC, serum creatinine, CK-MB, TNT, hs-CRP, TG, TC, LDL-C, BNP in the death group were significantly higher than those in the survival group, and HDL-C was significantly lower than that of the survival group(P<0.01). Serum hs-CRP, CK-MB, TNT and BNP in the survival group after thrombolysis were significantly lower than those before thrombolysis(P<0.05). The successful rate of thrombolysis in death group was significantly lower than that in the survival group(P<0.01). Conclusion Age, elevated levels of hs-CRP and serum creatinine, anterior MI, LDL-C,BNP, HDL-C levels, cardiogenic shock occurred during hospital and Killip class ≥II level are the prognosis and influence factors in patients with STEMI complicated with heart failure. |
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