临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
2期
181-184
,共4页
李臣%骆琪芳%刘亚丽%王晓凤
李臣%駱琪芳%劉亞麗%王曉鳳
리신%락기방%류아려%왕효봉
心肌梗塞%心力衰竭%溶栓%危险因素%代谢综合征%预后
心肌梗塞%心力衰竭%溶栓%危險因素%代謝綜閤徵%預後
심기경새%심력쇠갈%용전%위험인소%대사종합정%예후
myocardial infarction%heart failure%thrombolysis%risk factors%metabolic syndrome%prognosis
目的：探讨急性心肌梗死溶栓再通后住院期间发生心力衰竭的危险因素。方法选取我院住院的急性ST 段抬高型心肌梗死(STEMI)溶栓再通后的患者130例,根据住院期间是否发生心力衰竭,分为心力衰竭组31例和非心力衰竭组99例。比较两组患者一般临床特征、危险因素、血压、白细胞计数(WBC)、肌钙蛋白(cTnI)、生化指标、心肌梗死面积(MIA)、左心室射血分数(LVEF)、B 型脑钠肽(BNP)等相关指标,分析 STEMI 患者溶栓再通后住院期间发生心力衰竭的因素。结果2组间年龄、糖尿病史、发病到血管再通时间、收缩压、前壁心肌梗死及广泛前壁心肌梗死比例、MIA、血糖、cTnI、WBC、γ-谷氨酰转肽酶(GGT)、LVEF、BNP 比较,差异具有统计学意义(P <0.05)。发病到血管再通时间延长(OR =4.402,95% CI =1.565~12.382)、收缩压升高(OR =1.095,95% CI =1.019~1.175)、高血糖(OR =2.132,95% CI =1.127~4.033)、高 cTnI(OR =1.352,95% CI =1.031~1.773)、GGT 升高(OR =1.182,95% CI =1.204~1.365)、高 MIA(OR =1.656,95% CI =1.162~2.360)是 STEMI 溶栓再通患者住院期间发生心力衰竭的危险因素。结论发病到血管再通时间延长、收缩压升高、高血糖、高 cTnI、GGT 升高及高MIA 是 STEMI 溶栓再通患者住院期间发生心力衰竭的危险因素。
目的：探討急性心肌梗死溶栓再通後住院期間髮生心力衰竭的危險因素。方法選取我院住院的急性ST 段抬高型心肌梗死(STEMI)溶栓再通後的患者130例,根據住院期間是否髮生心力衰竭,分為心力衰竭組31例和非心力衰竭組99例。比較兩組患者一般臨床特徵、危險因素、血壓、白細胞計數(WBC)、肌鈣蛋白(cTnI)、生化指標、心肌梗死麵積(MIA)、左心室射血分數(LVEF)、B 型腦鈉肽(BNP)等相關指標,分析 STEMI 患者溶栓再通後住院期間髮生心力衰竭的因素。結果2組間年齡、糖尿病史、髮病到血管再通時間、收縮壓、前壁心肌梗死及廣汎前壁心肌梗死比例、MIA、血糖、cTnI、WBC、γ-穀氨酰轉肽酶(GGT)、LVEF、BNP 比較,差異具有統計學意義(P <0.05)。髮病到血管再通時間延長(OR =4.402,95% CI =1.565~12.382)、收縮壓升高(OR =1.095,95% CI =1.019~1.175)、高血糖(OR =2.132,95% CI =1.127~4.033)、高 cTnI(OR =1.352,95% CI =1.031~1.773)、GGT 升高(OR =1.182,95% CI =1.204~1.365)、高 MIA(OR =1.656,95% CI =1.162~2.360)是 STEMI 溶栓再通患者住院期間髮生心力衰竭的危險因素。結論髮病到血管再通時間延長、收縮壓升高、高血糖、高 cTnI、GGT 升高及高MIA 是 STEMI 溶栓再通患者住院期間髮生心力衰竭的危險因素。
목적：탐토급성심기경사용전재통후주원기간발생심력쇠갈적위험인소。방법선취아원주원적급성ST 단태고형심기경사(STEMI)용전재통후적환자130례,근거주원기간시부발생심력쇠갈,분위심력쇠갈조31례화비심력쇠갈조99례。비교량조환자일반림상특정、위험인소、혈압、백세포계수(WBC)、기개단백(cTnI)、생화지표、심기경사면적(MIA)、좌심실사혈분수(LVEF)、B 형뇌납태(BNP)등상관지표,분석 STEMI 환자용전재통후주원기간발생심력쇠갈적인소。결과2조간년령、당뇨병사、발병도혈관재통시간、수축압、전벽심기경사급엄범전벽심기경사비례、MIA、혈당、cTnI、WBC、γ-곡안선전태매(GGT)、LVEF、BNP 비교,차이구유통계학의의(P <0.05)。발병도혈관재통시간연장(OR =4.402,95% CI =1.565~12.382)、수축압승고(OR =1.095,95% CI =1.019~1.175)、고혈당(OR =2.132,95% CI =1.127~4.033)、고 cTnI(OR =1.352,95% CI =1.031~1.773)、GGT 승고(OR =1.182,95% CI =1.204~1.365)、고 MIA(OR =1.656,95% CI =1.162~2.360)시 STEMI 용전재통환자주원기간발생심력쇠갈적위험인소。결론발병도혈관재통시간연장、수축압승고、고혈당、고 cTnI、GGT 승고급고MIA 시 STEMI 용전재통환자주원기간발생심력쇠갈적위험인소。
Objective To investigate the risk factors for hospitalization heart failure for inpatients with acute ST-segment elevation myocardial infarction(STEMI)after successful thrombolysis.Methods A total of 130 inpatients with STEMI after successful thrombolysis in our hospital were divided into heart failure group (n =31)and non-heart failure group (n =99)according to whether they suffered from hear failure during hospitalization.The clinical base line characteristics,risk factors,blood pressure,white blood cells (WBC),cardiac troponin I (cTnI),biochemical indicators,myocardial infarct area(MIA),left ventricular ejection fraction(LVEF),B type natriuretic peptide(BNP) were compared between two groups.Additionally,the hospital incidence of heart failure in patients with STEMI after successful thrombolysis was analyzed.Results Significant differences were found in age,diabetes mellitus history, time from onset to successful thrombolysis,systolic pressure,the proportion of anterior myocardial infarction and extensive anterior myocardial infarction,MIA, glucose (GLU ), cardiac troponin I (cTnI ), WBC, gamma-glutamyltransferase(GGT),LVEF,BNP between two groups (P < 0.05 ).Long time from onset to successful thrombolysis(OR =4.402,95% CI =1.565-12.382),high systolic pressure (OR =1.095,95% CI =1.01 9-1.1 75), admission hyperglycemia (OR =2.132,95% CI =1.127-4.033),high cTnI(OR =1.352,95% CI =1.031-1.773), high GGT(OR = 1.182,95% CI = 1.204-1.365 ),high MIA(OR = 1.656,95% CI = 1.1 62-2.360 )were the risk factors for heart failure.Conclusion Long time from onset to successful thrombolysis,high systolic pressure, admission hyperglycemia,high cTnI,high GGT and high MIA were the risk factors for heart failure in inpatients with acute STEMI after successful thrombolysis.
