中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2015年
6期
543-546
,共4页
贾静静%董平栓%杜来景%李志娟%范喜梅%王红雷%杨喜山%杨旭明
賈靜靜%董平栓%杜來景%李誌娟%範喜梅%王紅雷%楊喜山%楊旭明
가정정%동평전%두래경%리지연%범희매%왕홍뢰%양희산%양욱명
左心室舒张末期压力%ST段抬高型心肌梗死%死亡率
左心室舒張末期壓力%ST段抬高型心肌梗死%死亡率
좌심실서장말기압력%ST단태고형심기경사%사망솔
Left ventricular end-diastolic pressure%ST-segment elevation myocardial infarction%Mortality
目的：评估左心室舒张末期压力（LVEDP）对新发ST段抬高型心肌梗死（STEMI）患者行急诊经皮冠状动脉（冠脉）介入治疗（PCI）后死亡率的影响。方法：该研究为回顾性分析。入选255例行急诊PCI的新发STEMI患者，术中均在冠脉血管开通前测量LVEDP，根据LVEDP的均值[14 mmHg（1 mmHg=0.133 kPa）]分为LVEDP≤14 mmHg组和LVEDP＞14 mmHg组，观察术后6个月死亡率。运用Cox回归分析LVEDP对死亡率的影响。结果：相对LVEDP≤14 mmHg组，LVEDP＞14 mmHg组患者术后6个月死亡的风险比（HR）为4.26（P=0.03）。相关分析显示，LVEDP与左心室射血分数（r=-0.267，P=0.001）和B型利钠肽（r=0.154，P=0.041）呈轻度相关。多因素分析显示，在调整左心室射血分数及B型利钠肽后，LVEDP是术后6个月死亡的独立预测因素（每增加5 mmHg， HR=1.22，P=0.04）。结论：急诊PCI术中测量的LVEDP是新发STEMI患者术后死亡的独立预测因素。
目的：評估左心室舒張末期壓力（LVEDP）對新髮ST段抬高型心肌梗死（STEMI）患者行急診經皮冠狀動脈（冠脈）介入治療（PCI）後死亡率的影響。方法：該研究為迴顧性分析。入選255例行急診PCI的新髮STEMI患者，術中均在冠脈血管開通前測量LVEDP，根據LVEDP的均值[14 mmHg（1 mmHg=0.133 kPa）]分為LVEDP≤14 mmHg組和LVEDP＞14 mmHg組，觀察術後6箇月死亡率。運用Cox迴歸分析LVEDP對死亡率的影響。結果：相對LVEDP≤14 mmHg組，LVEDP＞14 mmHg組患者術後6箇月死亡的風險比（HR）為4.26（P=0.03）。相關分析顯示，LVEDP與左心室射血分數（r=-0.267，P=0.001）和B型利鈉肽（r=0.154，P=0.041）呈輕度相關。多因素分析顯示，在調整左心室射血分數及B型利鈉肽後，LVEDP是術後6箇月死亡的獨立預測因素（每增加5 mmHg， HR=1.22，P=0.04）。結論：急診PCI術中測量的LVEDP是新髮STEMI患者術後死亡的獨立預測因素。
목적：평고좌심실서장말기압력（LVEDP）대신발ST단태고형심기경사（STEMI）환자행급진경피관상동맥（관맥）개입치료（PCI）후사망솔적영향。방법：해연구위회고성분석。입선255례행급진PCI적신발STEMI환자，술중균재관맥혈관개통전측량LVEDP，근거LVEDP적균치[14 mmHg（1 mmHg=0.133 kPa）]분위LVEDP≤14 mmHg조화LVEDP＞14 mmHg조，관찰술후6개월사망솔。운용Cox회귀분석LVEDP대사망솔적영향。결과：상대LVEDP≤14 mmHg조，LVEDP＞14 mmHg조환자술후6개월사망적풍험비（HR）위4.26（P=0.03）。상관분석현시，LVEDP여좌심실사혈분수（r=-0.267，P=0.001）화B형리납태（r=0.154，P=0.041）정경도상관。다인소분석현시，재조정좌심실사혈분수급B형리납태후，LVEDP시술후6개월사망적독립예측인소（매증가5 mmHg， HR=1.22，P=0.04）。결론：급진PCI술중측량적LVEDP시신발STEMI환자술후사망적독립예측인소。
Objective: To evaluate the post-operative mortality of left ventricular end-diastolic pressure (LVEDP) during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: We retrospectively analyzed 255 patients with new onset of STEMI who received primary PCI in our hospital and all patients received LVEDP measurement before coronary artery opening. According to LVEDP value, the patients were divided into 2 groups: LVEDP≤14 mmHg group,n=155 and LVEDP>14 mmHg group,n=100. The post-operative mortality up to 6 months was observed, and the effect of LVEDP on death rate was studied by Cox regression analysis. Results: Compared with LVEDP≤14 mmHg group, the patients in LVEDP>14 mmHg group had the 6 months mortality at HR=4.26, 95% CI (1.13-16.08),P=0.03. Relevant study presented that LVEDP was slightly related to LVEF (r=-0.267, P=0.001) and BNP (r=-0.154,P=0.041). Multi-regression analysis indicated that with adjusted LVEF and BNP, LVEDP was the independent predictor for post-operative mortality up to 6 months in acute STEMI patients after PCI. Conclusion: The LVEDP value measured during PCI procedure is the independent predictor for mortality after PCI in patients with new onset of STEMI.
