摘要
目的探讨急性心肌梗死(AMI)合并心源性休克患者经皮冠状动脉介入术(PCI)治疗后出现院内死亡的危险因素。方法选取2018年6月—2023年6月在新疆医科大学第一附属医院心血管介入科行PCI治疗的180例AMI合并心源性休克患者作为研究对象,其中47例治疗无效出现院内死亡的患者纳入死亡组,同期133例经PCI治疗后康复出院的患者纳入存活组,通过建立Logistic回归模型分析引起AMI合并心源性休克患者PCI治疗后出现院内死亡的危险因素。结果死亡组患者的年龄、陈旧性心肌梗死患者比例大于存活组(t=2.947、5.068,均P<0.05);死亡组患者入院时的SBP低于存活组,肌酐、血乳酸、心率(HR)高于存活组(t=-2.175、3.136、2.870、2.045,均P<0.05);死亡组患者PCI后心肌梗死溶栓试验(TIMI)≥Ⅲ级的患者比例低于存活组(χ^(2)=7.840,P=0.005);死亡组患者PCI后心律失常发生率、急性肾损伤发生率、消化道出血发生率均高于存活组,差异具有统计学意义(χ^(2)=4.970、11.294、9.632,均P<0.05);年龄越大、入院时收缩压(SBP)降低、入院时HR越高、入院时肌酐越高、入院时血乳酸越高、PCI后TIMI血流分级≤Ⅱ级、合并急性肾损伤、合并消化道出血均会增加AMI合并心源性休克患者PCI后出现院内死亡的风险(均P<0.05)。结论AMI合并心源性休克患者经PCI治疗后出现院内死亡的危险因素较多,应针对重点人群给予早期干预,减少该类人群死亡风险。
Objective To investigate the risk factors for in-hospital death after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)combined with cardiogenic shock.Methods A total of 180 patients with AMI combined with cardiogenic shock who underwent PCI treatment in the Department of Cardiovascular Intervention,the First Affiliated Hospital of Xinjiang Medical University from June 2018 to June 2023 were selected as the research objects,Among them,47 patients who were treated ineffectively and died in hospital were included in the death group,and 133 patients who recovered and discharged after PCI treatment in the same period were included in the survival group,the risk factors for in-hospital death after PCI in patients with AMI combined with cardiogenic shock were analyzed by establishing Logistic regression model.Results The proportion of patients with age and old myocardial infarction was greater in the dead group than in the survival group(t=2.947,5.068,all P<0.05);the systolic blood pressure(SBP)of the death group was lower than that of the survival group at admission,and the creatinine,blood lactate and heart rate(HR)were higher than those of the survival group(t=-2.175,3.136,2.870,2.045,all P<0.05);the proportion of patients with TIMI grade≥Ⅲafter PCI in the death group was lower than that in the survival group(χ^(2)=7.840,P=0.005);the incidence of arrhythmia,acute kidney injury and gastrointestinal bleeding in the death group was higher than that in the survival group,which was statistically significant(χ^(2)=4.970,11.294,9.632,all P<0.05);older age,lower SBP at admission,higher HR at admission,higher creatinine at admission,higher lactate at admission,TIMI flow grade≤2 after PCI,acute kidney injury,and gastrointestinal bleeding increased the risk of in-hospital death after PCI in patients with AMI combined with cardiogenic shock(all P<0.05).Conclusion There are many risk factors for in-hospital death after PCI treatment in patients with AMI combined with cardiogenic shock,so early intervention should be given to key groups to reduce the risk of death in this group.
作者
马健
董霞
王宝珠
高小莉
MA Jian;DONG Xia;WANG Baozhu;GAO Xiaoli(Department of Intensive Care,Center of Cardiovascular Disease,the First Affiliated Hospital of Xinjiang Medical University,Urumqi the Xinjiang Uygur Autonomous Region 830000,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第6期706-709,714,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
新疆维吾尔自治区重点研发计划项目(2022B03022-5)。
关键词
急性心肌梗死
心源性休克
经皮冠状动脉介入术
死亡
危险因素
预防措施
Acute myocardial infarction
Cardiogenic shock
Percutaneous coronary intervention
Death
Risk factors
Preventive measure
