急性心肌梗死急诊经皮冠状动脉介入术后低血压的危险因素

Risk factors of hypotension after emergency percutaneous coronary intervention in acute myocardial infraction patient

目的探讨急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗术(PCI)后发生低血压的危险因素。方法收集我院2013年1月至2015年8月300例行急诊经皮冠状动脉介入术的患者资料,根据术后是否出现低血压症状分为低血压组和非低血压组,记录比较2组患者的一般情况、相关临床指标,并对危险因素进行logistics归回分析。结果 2组患者的一般情况比较,低血压组有心绞痛史少于非低血压组,且差异有统计学意义(P<0.05),其余一般情况比较,差异均无统计学意义(P>0.05)。2组患者LDL-C比较,差异无统计学意义(P>0.05);CK-MB峰值、下壁心肌梗死及右心室心肌梗死的比较,差异有统计学意义(P<0.05)。2组患者冠状动脉病变情况中多支病变的比较,差异无统计学意义(P>0.05),其余情况比较,差异具有统计学意义(P<0.05)。结论 CK-MB峰值、下壁心肌梗死、右心室心肌梗死及术后TIMI血流小于2级均为患者PCI术后低血压的危险因素。

Objective To explore the risk factors of hypotension of patient with acute myocardial infraction（ AMI） after emergency percutaneous coronary intervention（ PCI）. Methods The data of 300 patients with AMI who received PCI in our hospital from January 2015 to August 2015 were collected. According to the symptom of hypotension,the patients were divided into hypotension group and normal group. The general information and relative clinical data were recorded and compared. The risk factors were analyzed by logistics regressive analysis.Results The incidence of previous angina of hypotension group was lower than that of normal group,the difference was significant（P 0. 05）,there was no difference in other general information between two groups（ P 0. 05）. There was no difference in level of LDL-C between two groups（ P 0. 05）. And the differences in peak value of CK-MB,inferior wall or right ventricular infarction were statistical significance（P 0. 05）. There was no significant difference in multi-vessel lesions（P 0. 05）,and the difference in others of coronary artery lesion between two groups was statistical significance（ P 0. 05）. Conclusion The peak value of CK-MB,inferior wall or right ventricular infarction and TIMI 2 after PCI can increase the possibility of hypotension after PCI,and angina pectoris before infarction can reduce the incidence of hypotension after PCI.