经皮直接冠状动脉介入治疗ST段抬高型心肌梗死患者近中期预后的相关因素

A comparative study of prognosis and related factors in male and female myocardial infarction patients post PCI intervention

目的探讨行直接PCI的ST段抬高型心肌梗死患者近中期预后的相关因素。方法2003年7月-2005年12月住院且诊断为ST段抬高型心肌梗死（无心源性休克）患者199例,对这些患者进行住院期观察及出院后随访,随访时间为6个月。结果除女性年龄较大之外[（67±12）岁vs（60±11）岁,P〈0.01],两组间临床特征基本相似;住院病死率女性较高（9.1%vs1.5%,P〈0.05）;主要不良事件发生率女性也较高（12%vs3.0%,P〈0.01）。6个月病死率差异仍然存在[12%vs1.5%,P〈0.01];多因素分析显示死亡、心脏主要不良事件和稳定型心绞痛的相关因素：女性、80岁以上的年龄、多支血管病变、严重左室功能不全和术后未规范用药。结论女性、80岁以上、多支血管病变、严重左心室功能不全和术后未规范用药是行直接PC I的ST段抬高型心肌梗死患者近中期预后的主要预测因子。

AIM To determine the prognostic and related factors, both in-hospital and in six-month follow-up period, of patients admitted within the first twelve hours of ST-segment elevation acute myocardial infarction and underwent primary percutaneous coronary intervention. METHODS Enrolled in the study were 199 consecutive patients between July 2003 and December 2005, who were admitted with ST- segment elevation myocardial infarction and without cardiogenic shock. Their outcomes, gender and related factors in-hospital and in the six-month follow up period were studied. RESULTS Clinical characteristics were similar in both genders with exception of age [female 〉 male, （67 ± 12）years vs （60 ± 11 ） years, P 〈0.01 ]. The in-hospital CHD-related mortality and total CHD-related mortality were higher in females （9.1% vs 1.5%, P 〈0.05） and the total major CHD-related events in females and males were 12% and 3.0% respectively （P 〈0.01 ）. Muhifactory Cox regression analysis showed that the main risk factors of death or main CHD related events were gender （ female）, age （ over eighty years）, multiple vascular diseases and severe dysfunction of left ventricles. CONCLUSION Female gender, an age over eighty years, muhivessel disease and severe ventricular dysfunction are the main near-and-mid term predictors of prognosis in patients who had undergone primary percutaneous intervention.