急性非ST段抬高型心肌梗死患者合并心力衰竭的危险因素分析

Risk Factor Analysis of Heart Failure in Patients with Acute Non-ST-Segment Elevation Myocardial Infarction

目的研究不同造影剂对急性非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后心力衰竭的影响,探讨NSTEMI患者PCI术后心力衰竭的危险因素。方法入选375例行PCI术的NSTEMI患者,根据选用造影剂不同分为两组,碘克沙醇组(n=289)和碘海醇组(n=86),比较两组PCI术后心力衰竭发生率。采用多因素logistics逐步回归分析NSTEMI患者发生心力衰竭的危险因素。结果 (1)碘克沙醇组PCI术后心力衰竭发生率低于碘海醇组,但组间比较差异无统计学意义(P>0.05)。(2)多因素logistic回归分析显示,高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、2型糖尿病、年龄、高血压依次为NSTEMI患者PCI术后合并心力衰竭的危险因素(OR分别为2.234,1.942,1.017,1.738,P均<0.01)。结论不同造影剂对NSTEMI患者PCI术后合并心力衰竭无影响,在冠心病危险因素中,年龄、高血压病、2型糖尿病以及hs-CRP是NSTEMI患者合并心力衰竭的危险因素。

Objective To investigate the effects of different contrast agents on heart failure after percutaneous coronary intervention（PCI）in patients with non-ST-segment elevation myocardial infarction（NSTEMI）,and explore the risk factors of heart failure in NSTEMI patients after PCI.Methods A total of 375 NSTEMI patients underwent PCI were divided into two groups according to the different use of contrast agent：iodixanol group（n=289）and iohexol group（n=86）,the incidence of heart failure after PCI between two groups were analyzed and compared.The risk factors of heart failure in NSTEMI patients were analyzed by using multivariate logistics regression analysis.Results（1）The incidence of heart failure after PCI in the iodixanol group was lower than that in the iohexol group（P0.05）.（2）Multivariate logistic regression（forward method）analysis showed that high-sensitivity C-reactive protein（hs-CRP）,type 2 diabetes mellitus,age and hypertension were the risk factors for heart failure in NSTEMI patients after PCI（OR were 2.234,1.942,1.017,1.738,All P0.01）.Conclusion Different contrast agents have no effect on heart failure in NSTEMI patients after PCI.Among the risk factors of coronary heart diseases,age,hypertension,type 2 diabetes and hs-CRP are the risk factors of NSTEMI complicated with heart failure.