摘要
目的分析急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)治疗后心力衰竭发生情况及危险因素。方法回顾性分析2021年3月~2024年3月8于南京医科大学第四附属医院行PCI的134例STEMI患者的临床资料,根据术后住院期间并发心力衰竭情况分为非心力衰竭组(n=97)和心力衰竭组(n=37),分析PCI后并发心力衰竭的影响因素。结果心力衰竭组中女性、有糖尿病史、心房颤动、心律失常的患者比例均高于非心力衰竭组(χ^(2)=7.110、4.130、4.793、4.556,P<0.05),年龄、收缩压、舒张压、心率、血糖、D-二聚体水平、神经末端前体B型利钠肽(NT-proBNP)水平、左室收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)亦均高于非心力衰竭组(t=5.208、4.275、2.102、2.457、6.012、7.882、6.403、3.824、4.451,P<0.05),左室射血分数(LVEF)水平低于非心力衰竭组(t=5.628,P<0.05);多因素分析结果显示,性别、年龄、心房颤动、室性心律失常、血糖、D-二聚体水平、NT-proBNP水平、LVEF均是STEMI患者PCI后并发心力衰竭的影响因素(P<0.05)。结论STEMI患者PCI后心力衰竭的发生率较高,发生风险受性别、年龄、心房颤动、室性心律失常、入院时血糖、D-二聚体水平、NT-proBNP水平和LVEF的影响。
Objective To analyze the incidence and risk factors of heart failure in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The data of 134 patients with STEMI who received PCI in the Fourth Affiliated Hospital of Nanjing Medical University were retrospectively analyzed from March 2021 to March 2024.According to the postoperative heart failure during hospitalization,they were divided into non-heart failure group(n=97)and heart failure group(n=37).The differences in data were compared between groups.Logistic regression analysis was used to analyze the influencing factors of heart failure after PCI.Results Compared to the non-heart failure group,the heart failure group had higher proportions of female sex(χ^(2)=7.110,P<0.05),diabetes mellitus(χ^(2)=4.130,P<0.05),atrial fibrillation(χ^(2)=4.793,P<0.05),and ventricular arrhythmia(χ^(2)=4.556,P<0.05).The age,systolic blood pressure,diastolic blood pressure,heart rate,blood glucose,D-dimer,NT-proBNP,LVESD and LVEDD were significantly higher in heart failure group than those in non-heart failure group(t=5.208,4.275,2.102,2.457,6.012,7.882,6.403,3.824,4.451,P<0.05)while the LVEF was significantly lower(t=5.628,P<0.05).Logistic regression analysis showed that gender,age,atrial fibrillation,ventricular arrhythmia,blood glucose,D-dimer,NT-proBNP and LVEF were the influencing factors of heart failure after PCI in STEMI patients(P<0.05).Conclusion Heart failure occurs frequently after PCI in STEMI patients,with independent risk factors including female,advanced age,atrial fibrillation,ventricular arrhythmia,elevated blood glucose,D-dimer,NT-proBNP levels and reduced LVEF.
作者
牛珂
付蓉蓉
张亚娟
Niu Ke;Fu Rongrong;Zhang Yajuan(Department of Emergency,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China)
出处
《中华保健医学杂志》
2025年第3期396-399,共4页
Chinese Journal of Health Care and Medicine
基金
2021年南京市卫生科技发展专项资金项目(YKK21250)。
