浙江临床医学
浙江臨床醫學
절강림상의학
Zhejiang Clinical Medical Journal
2015年
9期
1505-1506,1507
,共3页
顾军清%范建华%谢佳%宋建平
顧軍清%範建華%謝佳%宋建平
고군청%범건화%사가%송건평
急性心肌梗死%低钙血症%远期预后
急性心肌梗死%低鈣血癥%遠期預後
급성심기경사%저개혈증%원기예후
Acute myocardial infarction%Hypocalcemia%Precordial S-T segment elevation%Long-term prognosis
目的：探讨ST段抬高且入院后行急诊PCI的急性心肌梗死患者低钙血症的发生及与患者预后的关系。方法 ST段抬高急诊行PCI的患者155例，按照入院时血浆钙离子浓度分为非低钙血症组122例（78.71%），低钙血症组33例（21.29%）。比较两组患者一般情况、基础疾病、发病时心率、冠状动脉病变情况、入院时心超EF值、肌钙蛋白、肾功能以及临床远期预后情况。结果低钙血症组糖尿病、高脂血症发生率比非低钙血症组高，差异有统计学意义（P=0.022、0.014），低钙血症组肾功能比非低钙血症组差，差异有统计学意义（P=0.026）。冠状动脉造影显示，低钙血症组患者前壁及广泛前壁心肌梗死发生率比非低钙血症组高，差异有统计学意义（P=0.044），且单支病变发生率高于非低钙血症组，差异有统计学意义（P=0.00）。两组再发心肌梗死、猝死的心血管事件发生率，差异无统计学意义（P=0.748、0.250、0.854）。结论低钙血症的急性ST段抬高的患者基础疾病较多，肾功能差及单支血管病变严重。
目的：探討ST段抬高且入院後行急診PCI的急性心肌梗死患者低鈣血癥的髮生及與患者預後的關繫。方法 ST段抬高急診行PCI的患者155例，按照入院時血漿鈣離子濃度分為非低鈣血癥組122例（78.71%），低鈣血癥組33例（21.29%）。比較兩組患者一般情況、基礎疾病、髮病時心率、冠狀動脈病變情況、入院時心超EF值、肌鈣蛋白、腎功能以及臨床遠期預後情況。結果低鈣血癥組糖尿病、高脂血癥髮生率比非低鈣血癥組高，差異有統計學意義（P=0.022、0.014），低鈣血癥組腎功能比非低鈣血癥組差，差異有統計學意義（P=0.026）。冠狀動脈造影顯示，低鈣血癥組患者前壁及廣汎前壁心肌梗死髮生率比非低鈣血癥組高，差異有統計學意義（P=0.044），且單支病變髮生率高于非低鈣血癥組，差異有統計學意義（P=0.00）。兩組再髮心肌梗死、猝死的心血管事件髮生率，差異無統計學意義（P=0.748、0.250、0.854）。結論低鈣血癥的急性ST段抬高的患者基礎疾病較多，腎功能差及單支血管病變嚴重。
목적：탐토ST단태고차입원후행급진PCI적급성심기경사환자저개혈증적발생급여환자예후적관계。방법 ST단태고급진행PCI적환자155례，안조입원시혈장개리자농도분위비저개혈증조122례（78.71%），저개혈증조33례（21.29%）。비교량조환자일반정황、기출질병、발병시심솔、관상동맥병변정황、입원시심초EF치、기개단백、신공능이급림상원기예후정황。결과저개혈증조당뇨병、고지혈증발생솔비비저개혈증조고，차이유통계학의의（P=0.022、0.014），저개혈증조신공능비비저개혈증조차，차이유통계학의의（P=0.026）。관상동맥조영현시，저개혈증조환자전벽급엄범전벽심기경사발생솔비비저개혈증조고，차이유통계학의의（P=0.044），차단지병변발생솔고우비저개혈증조，차이유통계학의의（P=0.00）。량조재발심기경사、졸사적심혈관사건발생솔，차이무통계학의의（P=0.748、0.250、0.854）。결론저개혈증적급성ST단태고적환자기출질병교다，신공능차급단지혈관병변엄중。
ObjectiveTo determine the prevalence and prognostic implication of hypocalcemia in the ST-elevation myocardial infarctionpatients. Methods Restrospective analysis of collected data on 155 PCI-treated STEMI patients 55-80y at The First Affiliated Hospital of Soochow University between January 2014 and October 2014 was performed.A tolal of 155 cases with acute myocardial infarction combined with acute Percutaneous Coronary Intervention were enrolled in the study.155patients were dividedinto two groups according to the plasma calcium concentration : the normal control group 122(78.71%) and the hypocalcemia group 33(21.29%). Data of the general condition,underling diseases,heart rate,coronary disease,left ventricular ejection fraction of admission into hospital,cardiac troponin and longterm progrosis were compared between the two groups and analyzed.ResultsPatients with hypocalcemia had a significantly higher rate than the control group in diabetes and hyperlipemia(P=0.022, 0.014). Renal function of the hypercalcimia group is worse than the control group. The results of coronary angiography showed that there were significant differences between the hypocalcemia group and the control group with regard to the percentage of anterior wall myocardial infarction, single coronary lesion in the group hypercardial were significantly higher than the control group.During a follow-up investigation,cardiac events (heart failure,reinfarction,sudden death),the incidence rates of the hypercardial group were also higher than the control group,but there was no significant difference between them(P=0.748、0.250、0.854).Conclusion The ST-elevation patients with hypocalcamia had a severier underlying diseases,renal disfunction and worse single coronary lesion condition.
