急性心肌梗死合并心源性休克经皮冠状动脉介入治疗术后死亡的风险因素分析

Risk factors for death after percutaneous coronary intervention in patients of acute myocardial infarction combined with cardiogenic shock

目的分析急性心肌梗死（AMI）合并心源性休克（CS）患者经皮冠状动脉介入治疗（PCI）术后死亡的风险因素。方法回顾性分析46例接受了PCI治疗的AMI患者（男35例，女11例，年龄42～95岁，存活出院27例，院内死亡19例）的临床资料，应用多因素Logistic回归模型分析与AMI合并cS患者PCI术后死亡相关的风险因素。结果死亡组年龄（74．37±10．26）岁，显著长于存活组[（62．96±10．40）岁]（P〈0．05）；死亡组中有心肌梗死史者，并发糖尿病及高血压者的比例均显著高于存活组（均P〈0．05）。死亡组血肌酐（Cr）峰值为（137．74±52．40）μmmol／L，显著高于存活组【（94．48±25．18）μmmol／L]，死亡组左室射血分数（EF）为（31．05±8．43）％，显著低于存活组[（38．93±8．40）％]（均P〈0．05）。结论年龄≥65岁、陈旧性心肌梗死、糖尿病、高血压、EF〈35％、肾功能不全（Cr〉133μmol／L）是AMI合并CS患者PCI术后死亡的相关风险因素。

Objective To investigate the risk factors for death after percutaneous coronary intervention （PCI） in patients of acute myocardial infarction （AMI） combined with eardiogenic shock （CS）. Methods The clinical data of 46 patients of AMI combined with CS undergoing PCI, 35 males and 11 females, aged 42-95, of which 27 survived and were discharged from hospital and 19 died in hospital, were analyzed. Multivariate Logistic regression model was used to analyze the risk factors for death after PCI. Results The age of the death group was （74.37±10.26） years, significantly elder than that of the survival group [（62.96 ±10.40） years, P〈 0.05]. The proportions of those with cardiac infarction history, diabetes, and hypertension in the death group were all significantly higher than those in the survival group （all P〈0.05）. The peak serum ereatinine （Cr） level of the death group was （137.74±52.40） μmmol/L, significantly higher than that of the survival group [（94.48±25.18） μmmol/L, P〈0.05]. The left ventricular ejection fraction （EF） of the death group was （31.05±8.43）%, signifieandy lower than that of the survival group [（38.93±8.40）%, /9〈0.05]. Conclusion Age〉≥65 years, previous myocardial infarction, diabetes, hypertension, EF 〈 35%, and renal insufficiency （Cr 〉 133 μmol/L） are the risk factors for death after PCI in the patients of AMI combined with CS.