心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2015年
4期
434-438
,共5页
心肌梗死%血管成形术,气囊,冠状动脉%预后
心肌梗死%血管成形術,氣囊,冠狀動脈%預後
심기경사%혈관성형술,기낭,관상동맥%예후
Myocardial infarction%Angioplasty,balloon,coronary%Prognosis
目的：分析急性非 ST 段抬高心肌梗死（NSTEMI）患者介入治疗时机与长期结局的关系。方法：选择948例急性 NSTEMI 患者纳入研究。根据 NSTEMI 介入治疗方案分为早期介入治疗（48 h 内接受介入治疗，411例）组及晚期介入治疗（≥48h 接受介入治疗，537例）组。根据 TIMI 危险评分又分为低危、中危、高危三个亚组，比较各组的长期临床结局。结果：随访1年，与晚期介入组比较，早期介入组住院死亡率（4.8％比2.2％）和主要不良心血管事件发生率（MACE，13.4％比10.0％）明显降低（P 均＜0.01）；早期介入组中，中低危患者住院死亡率显著低于高危患者（3.3％比8.9％，P ＜0.01）。多元回归分析结果表明，老年及高 Killip 分级、左室射血分数减低、高 TIMI 危险评分、晚期介入治疗是 NSTEMI 患者长期临床结局的独立危险因素（OR＝1.027～2.079，P＜0.05或＜0.01）。结论：早期介入治疗对于高危险的急性非 ST 段抬高型心肌梗死患者有改善预后的作用。
目的：分析急性非 ST 段抬高心肌梗死（NSTEMI）患者介入治療時機與長期結跼的關繫。方法：選擇948例急性 NSTEMI 患者納入研究。根據 NSTEMI 介入治療方案分為早期介入治療（48 h 內接受介入治療，411例）組及晚期介入治療（≥48h 接受介入治療，537例）組。根據 TIMI 危險評分又分為低危、中危、高危三箇亞組，比較各組的長期臨床結跼。結果：隨訪1年，與晚期介入組比較，早期介入組住院死亡率（4.8％比2.2％）和主要不良心血管事件髮生率（MACE，13.4％比10.0％）明顯降低（P 均＜0.01）；早期介入組中，中低危患者住院死亡率顯著低于高危患者（3.3％比8.9％，P ＜0.01）。多元迴歸分析結果錶明，老年及高 Killip 分級、左室射血分數減低、高 TIMI 危險評分、晚期介入治療是 NSTEMI 患者長期臨床結跼的獨立危險因素（OR＝1.027～2.079，P＜0.05或＜0.01）。結論：早期介入治療對于高危險的急性非 ST 段抬高型心肌梗死患者有改善預後的作用。
목적：분석급성비 ST 단태고심기경사（NSTEMI）환자개입치료시궤여장기결국적관계。방법：선택948례급성 NSTEMI 환자납입연구。근거 NSTEMI 개입치료방안분위조기개입치료（48 h 내접수개입치료，411례）조급만기개입치료（≥48h 접수개입치료，537례）조。근거 TIMI 위험평분우분위저위、중위、고위삼개아조，비교각조적장기림상결국。결과：수방1년，여만기개입조비교，조기개입조주원사망솔（4.8％비2.2％）화주요불양심혈관사건발생솔（MACE，13.4％비10.0％）명현강저（P 균＜0.01）；조기개입조중，중저위환자주원사망솔현저저우고위환자（3.3％비8.9％，P ＜0.01）。다원회귀분석결과표명，노년급고 Killip 분급、좌실사혈분수감저、고 TIMI 위험평분、만기개입치료시 NSTEMI 환자장기림상결국적독립위험인소（OR＝1.027～2.079，P＜0.05혹＜0.01）。결론：조기개입치료대우고위험적급성비 ST 단태고형심기경사환자유개선예후적작용。
Objective:To analyze relationship between early intervention treatment and long-term prognosis in pa-tients with acute non-ST segment elevation myocardial infarction (NSTEMI).Methods:A total of 948 acute NSTE-MI patients were enrolled.According to NSTEMI intervention treatment timing,they were divided into early inter-vention group (received intervention treatment within 48h n=411,)and late intervention group (received interven-tion treatment after48h,n=537).According to TIMI risk score,the two groups were further divided into low risk subgroup,medium risk subgroup and high risk subgroup,the clinic long-term outcome was compared among all groups.Results:Compared with late intervention group,during one year follow-up,there were significant reduction in mortality during hospitalization (4.8% vs.2.2%)and incidence rate of major adverse cardiovascular events (MACE,13.4% vs.10.0%)in early intervention group,P <0.01 both;in early intervention group,mortality dur-ing hospitalization of low and medium risk patients was significantly lower than that of high risk patients (3.3% vs. 8.9%,P <0.01).Multi-factor regression analysis indicated that aged,high Killip class,reduced left ventricular e-jection fraction,high TIMI risk score and late intervention treatment were independent risk factors for clinic long-term outcome in NSTEMI patients (OR=1.027~2.079,P <0.05 or <0.01).Conclusion:Early intervention treat-ment can improve prognosis in NSTEMI patients.
