中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2014年
11期
999-1002
,共4页
老年%急性心肌梗死( AMI)%医院死亡率%预测因素%经皮冠状动脉介入术( PCI)
老年%急性心肌梗死( AMI)%醫院死亡率%預測因素%經皮冠狀動脈介入術( PCI)
노년%급성심기경사( AMI)%의원사망솔%예측인소%경피관상동맥개입술( PCI)
Elderly%Acute myocardial infarction ( AMI)%Hospital mortality%Predictors%Percutaneous coronary intervention(PCI)
目的探讨老年急性心肌梗死( AMI)急诊经皮冠状动脉介入( PCI)后院内死亡的原因并分析可预测院内死亡的因素。方法回顾分析2012-01~2012-12期间177例老年AMI患者行急诊PCI治疗的临床资料,按院内是否死亡分为生存组和死亡组。经多因素Logistic回归分析,筛选出与死亡相关的危险因素,并绘制ROC曲线来判断预测效果。结果①AMI患者院内死亡与心力衰竭、糖尿病比例、乳酸脱氢酶( LDH)、肌酸激酶( CK)、肌酸激酶-同工酶峰值( CK-MB)、肌钙蛋白I(TnI)、超敏C-反应蛋白(hs-CRP)和血尿酸(UA)呈正相关,与甘油三酯(TG)、胆固醇(TC)指标呈负相关,各组比较差异有统计学意义(P<0.05)。②多因素Logistic回归分析显示,心力衰竭(OR=8.741,P=0.000)和血UA(OR=1.008,P=0.000)是院内发生死亡的独立预测因素。 ROC曲线下面积为0.885(95%CI 0.818~0.952,P=0.000)。结论心力衰竭和血尿酸均为老年AMI患者急诊行PCI术后院内死亡的独立危险因素,其中心力衰竭的相对危险度最大。
目的探討老年急性心肌梗死( AMI)急診經皮冠狀動脈介入( PCI)後院內死亡的原因併分析可預測院內死亡的因素。方法迴顧分析2012-01~2012-12期間177例老年AMI患者行急診PCI治療的臨床資料,按院內是否死亡分為生存組和死亡組。經多因素Logistic迴歸分析,篩選齣與死亡相關的危險因素,併繪製ROC麯線來判斷預測效果。結果①AMI患者院內死亡與心力衰竭、糖尿病比例、乳痠脫氫酶( LDH)、肌痠激酶( CK)、肌痠激酶-同工酶峰值( CK-MB)、肌鈣蛋白I(TnI)、超敏C-反應蛋白(hs-CRP)和血尿痠(UA)呈正相關,與甘油三酯(TG)、膽固醇(TC)指標呈負相關,各組比較差異有統計學意義(P<0.05)。②多因素Logistic迴歸分析顯示,心力衰竭(OR=8.741,P=0.000)和血UA(OR=1.008,P=0.000)是院內髮生死亡的獨立預測因素。 ROC麯線下麵積為0.885(95%CI 0.818~0.952,P=0.000)。結論心力衰竭和血尿痠均為老年AMI患者急診行PCI術後院內死亡的獨立危險因素,其中心力衰竭的相對危險度最大。
목적탐토노년급성심기경사( AMI)급진경피관상동맥개입( PCI)후원내사망적원인병분석가예측원내사망적인소。방법회고분석2012-01~2012-12기간177례노년AMI환자행급진PCI치료적림상자료,안원내시부사망분위생존조화사망조。경다인소Logistic회귀분석,사선출여사망상관적위험인소,병회제ROC곡선래판단예측효과。결과①AMI환자원내사망여심력쇠갈、당뇨병비례、유산탈경매( LDH)、기산격매( CK)、기산격매-동공매봉치( CK-MB)、기개단백I(TnI)、초민C-반응단백(hs-CRP)화혈뇨산(UA)정정상관,여감유삼지(TG)、담고순(TC)지표정부상관,각조비교차이유통계학의의(P<0.05)。②다인소Logistic회귀분석현시,심력쇠갈(OR=8.741,P=0.000)화혈UA(OR=1.008,P=0.000)시원내발생사망적독립예측인소。 ROC곡선하면적위0.885(95%CI 0.818~0.952,P=0.000)。결론심력쇠갈화혈뇨산균위노년AMI환자급진행PCI술후원내사망적독립위험인소,기중심력쇠갈적상대위험도최대。
Objective To investigate the causes of the in -hospital death due to emergency treatment of percutaneous coronary intervention ( PCI ) on elderly acute myocardial infarction ( AMI ) patients and the predictable factors lead to the death.Methods One hundred and seventy -seven elderly AMI patients who were treated by the percutaneous coronary intervention ( PCI ) from January 2012 to December 2012 in the hospital were divided into death group andsurvival group, and their clinical data were statistically analyzed.Risk factors related to death were analyzed by multifactorial logistic regression analysis and the predicted effect was determinedby ROC curve.Results ①The in-hospital death was positively associated with heart failure, LDH, CK, CK-MB, TnI, Hs-CRP and UA, and was negatively associated with TG and TC, where the difference between groups is statistically significant (P<0.05).②Multifactorial logistic regression analysis showed that heart failure (OR=8.741,P=0.000), UA( OR=1.008,P=0.000) are independent predictor of in-hospital death. ROC curve analysis for this prediction model showed that the area under the curve was 0.885 (95%CI 0.818~0.952, P=0.000).Conclusion Heart failure and UA are independent risk factors for elderly patients with AMI hospital mortality after PCI, where the heart failure is of the largest risk level.