摘要
目的:探讨急性心肌梗死患者再灌注失败的预后评估方法。方法:选取2013-12-2015-12在本院急救中心和心内科诊治的ST段抬高型急性心肌梗死未行再灌注治疗或再灌注失败200例患者,观察2周内是否发生严重的心肌梗死并发症和主要心血管事件(MACE)将其分成2组:A组(发生严重的心血管事件组)、B组(未发生严重的心血管事件组),每例患者根据临床资料分析其梗死的罪犯血管、监测心肌酶(CK-MB)峰值、24血乳酸清除率水平、记录一般资料(年龄、性别、病史、吸烟史)、入院后24h的血常规、电解质、BNP、RS-CRP、PH、D-二聚体等。应用SPSS 17.0软件对各组进行单因素分析及Logistic回归分析,比较其危险因素与发生严重心血管事件的关联程度。结果:A组[罪犯血管为前降支、CK-MB>500 U/L、24h乳酸清除率<10%、年龄>70岁、病史、BNP、RS-CRP、D-二聚体]均高于B组(P均<0.05)其中影响预测是否发生严重心血管事件因素:罪犯血管为前降支(OR=9.23)、CK-MB酶峰>500U/L(OR=7.35)、年龄>70岁(OR=5.13)、及24h血乳酸清除率<10%(OR=4.52)。结论:罪犯血管、心肌酶峰、年龄及早期血乳酸清除率是预测急性梗死急诊静脉溶栓患者发生严重心血管事件的独立危险因素。
Objective：To investigate the prognosis of patients with acute myocardial infarction reperfusion failed assessment.Method：Select December 2013-2015 in December Kaifeng Central Hospital Emergency Center and Cardiology Diagnosis and Treatment of ST segment elevation acute myocardial infarction did not undergo reperfusion therapy or reperfusion failure 200 patients,observation two weeks whether serious complications following myocardial infarction and major cardiovascular events（MACE）occurred will be divided into two groups：A group（occurrence of serious cardiovascular events group）,group B（without the occurrence of serious cardiovascular events group）,each patient according to clinical data analysis of the infarction criminals blood vessels,monitoring myocardial enzymes（CK-MB）peak,24 blood lactate clearance level,record general information（age,gender,history,smoking history）,and 24 hours after admission blood routine,electrolyte,the BNP,RS-CRP,PH,Ddimer,etc.Application of SPSS 17.0software for each single factor analysis and Logistic regression analysis,compare the degree of risk factors associated with serious cardiovascular events.Result：group A [the culprit vessel was anterior descending,CK-MB greater than 500U/L and 24 hour lactic acid clearance rate of less than 10%,age〉70years old,medical history,BNP,RS-CRP,D-dimer]were higher than in group B（P〈0.05）in which factors predict whether A serious cardiovascular events：anterior descending blood vessels for criminal（OR=9.23）,CK-MB enzyme peak more than 500U/L（OR=7.35）,age〉70years old（OR=5.13）,and 24-hour blood lactate clearance rate〈10%（OR=4.52）.Conclusion：The culprit vessel,myocardial enzyme peak,early age and blood lactate clearance rate is an independent risk factor after acute infarction in emergency intravenous thrombolysis in patients with severe cardiovascular events.
出处
《临床急诊杂志》
CAS
2016年第9期688-691,共4页
Journal of Clinical Emergency
基金
开封市科技发展计划项目(No:130325)
关键词
急性心肌梗死
再灌注
预后
acute myocardial infarction
reperfusion
prognosis
