中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
8期
898-902
,共5页
金帅%桑真真%贾冬%许云%张鹏思%赵敏
金帥%桑真真%賈鼕%許雲%張鵬思%趙敏
금수%상진진%가동%허운%장붕사%조민
急性ST段抬高性心肌梗死%收缩压%预后%院内病死率%院内并发症%心源性休克%冠状动脉造影%再灌注治疗
急性ST段抬高性心肌梗死%收縮壓%預後%院內病死率%院內併髮癥%心源性休剋%冠狀動脈造影%再灌註治療
급성ST단태고성심기경사%수축압%예후%원내병사솔%원내병발증%심원성휴극%관상동맥조영%재관주치료
ST elevated acute myocardial infarction%Systolic blood pressure%Prognosis%In-hospital mortality%In-hospital complication%Cardiogenic shock%cCoronary angiography%Reperfusion
目的 研究入院时收缩压(systolic blood pressure-SBP)水平对急性ST段抬高心肌梗死(STEMI)在院期间预后的影响.方法 回顾性分析中国医科大学附属盛京医院2008年9月至2011年6月收治入院的335例STEMI患者,根据入院时SBP水平将335例STEMI患者分为4组,分别是:＜101 mmHg(1 mmHg=0.133 kPa) (n=59),101～120 mmHg (n=109),121 ～140mmHg(n=98),＞140 mmHg (n =69).比较各组的基本临床资料、冠状动脉造影发现(coronary angiography,CAG)、治疗方法、院内并发症和院内病死率.结果 各组STEMI患者院内病死率分别是18.64％、1.83％、4.08％、1.45％,入院SBP＜ 101 mmHg组病死率、killip≥3级、休克、严重心律失常发生率及经安装起搏器、IABP治疗率均高于其他3组.SBP≥101 mmHg的3组病死率没有明显差别.经多因素Logistic回归分析显示SBP＜ 101 mmHg(OR=6.368,P=0.002)、肌钙蛋白Ⅰ峰值(OR=3.781,P=0.008)是入院STEMI患者死亡的独立危险因素.结论 入院SBP＜ 101 mmHg患者在院期间病死率高,入院收缩压低可作为判断STEMI患者预后不良的一个较好指标.
目的 研究入院時收縮壓(systolic blood pressure-SBP)水平對急性ST段抬高心肌梗死(STEMI)在院期間預後的影響.方法 迴顧性分析中國醫科大學附屬盛京醫院2008年9月至2011年6月收治入院的335例STEMI患者,根據入院時SBP水平將335例STEMI患者分為4組,分彆是:＜101 mmHg(1 mmHg=0.133 kPa) (n=59),101～120 mmHg (n=109),121 ～140mmHg(n=98),＞140 mmHg (n =69).比較各組的基本臨床資料、冠狀動脈造影髮現(coronary angiography,CAG)、治療方法、院內併髮癥和院內病死率.結果 各組STEMI患者院內病死率分彆是18.64％、1.83％、4.08％、1.45％,入院SBP＜ 101 mmHg組病死率、killip≥3級、休剋、嚴重心律失常髮生率及經安裝起搏器、IABP治療率均高于其他3組.SBP≥101 mmHg的3組病死率沒有明顯差彆.經多因素Logistic迴歸分析顯示SBP＜ 101 mmHg(OR=6.368,P=0.002)、肌鈣蛋白Ⅰ峰值(OR=3.781,P=0.008)是入院STEMI患者死亡的獨立危險因素.結論 入院SBP＜ 101 mmHg患者在院期間病死率高,入院收縮壓低可作為判斷STEMI患者預後不良的一箇較好指標.
목적 연구입원시수축압(systolic blood pressure-SBP)수평대급성ST단태고심기경사(STEMI)재원기간예후적영향.방법 회고성분석중국의과대학부속성경의원2008년9월지2011년6월수치입원적335례STEMI환자,근거입원시SBP수평장335례STEMI환자분위4조,분별시:＜101 mmHg(1 mmHg=0.133 kPa) (n=59),101～120 mmHg (n=109),121 ～140mmHg(n=98),＞140 mmHg (n =69).비교각조적기본림상자료、관상동맥조영발현(coronary angiography,CAG)、치료방법、원내병발증화원내병사솔.결과 각조STEMI환자원내병사솔분별시18.64％、1.83％、4.08％、1.45％,입원SBP＜ 101 mmHg조병사솔、killip≥3급、휴극、엄중심률실상발생솔급경안장기박기、IABP치료솔균고우기타3조.SBP≥101 mmHg적3조병사솔몰유명현차별.경다인소Logistic회귀분석현시SBP＜ 101 mmHg(OR=6.368,P=0.002)、기개단백Ⅰ봉치(OR=3.781,P=0.008)시입원STEMI환자사망적독립위험인소.결론 입원SBP＜ 101 mmHg환자재원기간병사솔고,입원수축압저가작위판단STEMI환자예후불량적일개교호지표.
Objective To investigate the impact of systolic blood pressure (SBP) at admission on in-hospital outcomes in patients with ST elevated acute myocardial infarction (STEMI).Methods Data of 336 STEMI patients admitted from September 2008 to May 2011 were retrospectively analyzed.Total of 336 STEMI patients were classified into 4 groups as per the level of SBP at admission:group A (＜ 101 mmHg,n =59) ; group B (101-120 mmHg,n =109) ; group C (121-140 mmHg,n =98) and group D (＞ 140 mmHg,n =69).And clinical features,coronary angiography (CAG) findings,the strategy of treatment,complications and hospital mortality were compared among 4 groups with SPSS version 18.0 software.Results The mortality rates of the four groups were 18.64％,1.83％,4.08％,1.45％,respectively.The patients with SBP ＜ 106 mmHg were in greater risk of in-hospital mortality,Killip class ≥ 3 at admission,shock and refractory arrhythmias,and more patients in this group needed pacemaker and intraaortic balloon pump (IABP) treatment than patients in other 3 groups.While there was no significant difference in mortality rate between other three groups.Multivariate logistic regression analysis demonstrated SBP ＜ 101 mmHg (OR =6.368,P =0.002) and peak value of troponin Ⅰ (OR =3.781,P =0.008) were independent risk factors of in-hospital death in STEMI patients.Conclusions The STEMI patients with SBP ＜ 101 mmHg at admission had higher mortality rate and low SBP at admission had great prognostic value in short-term outcomes of STEMI.
