摘要
目的探讨心脏危重症患者机械循环辅助(MCS)治疗后血小板减少的影响因素。方法回顾性分析2021年1月1日至2021年11月1日于阜外华中心血管病医院心脏重症监护房使用MCS治疗的共计247例心脏危重症患者的临床资料,根据纳排标准排除51例,对196例患者的临床资料进行分析,统计患者血小板减少情况,分为减少组与未减少组,并进行单因素分析与Logistic多因素回归分析。结果196例患者中有125例患者出现血小板减少,发生率为63.78%;血小板减少组与未减少组相比,女性、血流感染、使用抗凝药物、使用抗血小板药物占比更高,年龄更大,MCS使用时间更长,差异有统计学意义(P<0.05);Logistic多因素分析结果显示,性别(OR=2.153)、年龄(OR=4.425)、血流感染(OR=3.486)、使用抗凝药物(OR=4.159)、使用抗血小板药物(OR=4.023)、MCS使用时间(OR=3.645)是影响心脏危重症患者MCS治疗后血小板减少的独立危险因素,差异有统计学意义(P<0.05)。结论心脏危重症患者MCS治疗后血小板减少受到性别、年龄、血流感染、使用抗凝药物、使用抗血小板药物、MCS使用时间等多种因素的影响,临床应加强对血流感染的控制,科学使用抗凝药物、抗血小板药物,合理安排MCS时间。
Objective To investigate the influencing factors of thrombocytopenia after mechanical circulatory assistance(MCS)therapy in critically ill cardiac patients.Methods The clinical data of a total of 247 critically ill cardiac patients treated with MCS in the Cardiac Intensive Care Unit of Fuwai Huazhong Cardiovascular Hospital from January 1,2021 to November 1,2021 were retrospectively analyzed.According to the inclusion and exclusion criteria,51 patients were excluded,and the clinical data of 196 patients were analyzed.Thrombocytopenia conditions of patients were counted,and they were divided into reduced and unreduced group.Univariate analysis and Logistic regression analysis were performed.Results Among 196 patients,125 had thrombocytopenia,and the incidence rate was 63.78%.Compared with the non-decreased group,the thrombocytopenia group had higher proportions of women,bloodstream infection,use of anticoagulants,and use of antiplatelet drugs,age was older,MCS use time was longer,the differences were statistically significant(P<0.05).Logistic multivariate analysis showed that gender(OR=2.153),age(OR=4.425),bloodstream infection(OR=3.486),use of anticoagulants(OR=4.159),use of antiplatelet drugs(OR=4.023),time of MCS use(OR=3.645)were independent risk factors for thrombocytopenia after MCS treatment in critically ill cardiac patients,the differences were statistically significant(P<0.05).Conclusion Thrombocytopenia in critically ill cardiac patients after MCS treatment is affected by various factors such as gender,age,bloodstream infection,use of anticoagulants,use of antiplatelet drugs,duration of MCS use,etc.In clinical practice,the control of bloodstream infection should be strengthened,anticoagulant drugs and antiplatelet drugs should be used scientifically,and MCS time should be reasonably arranged.
作者
王文华
张永春
WANG Wenhua;ZHANG Yongchun(Department of Coronary Heart Disease Intensive Care Unit,Fuwai Huazhong Cardiovascular Hospital,Zhengzhou Henan 450000,China;Department of Cardiology,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang Henan 453100,China)
出处
《临床研究》
2022年第11期5-8,共4页
Clinical Research
关键词
心脏危重症
MCS治疗
血小板减少
影响因素
cardiac critical illness
MCS treatment
thrombocytopenia
influencing factors
