急性心肌梗死患者行PCI后1年的生存状况及相关因素分析

Survival Status and Related Factors of Patients with Acute Myocardial Infarction One Year after Percutaneous Coronary Intervention

目的分析急性心肌梗死患者行经皮冠状动脉介入(PCI)后1年的生存状况及相关因素。方法回顾性分析170例急性心肌梗死患者临床资料,并根据PCI后1年的生存情况,分为死亡组与存活组。比较两组患者临床资料与实验室检查各项指标,采用多因素Logistic回归分析术后1年患者生存状况的影响因素。结果170例患者中,术后1年死亡12例(7.06%),存活158例(92.94%)。单因素分析结果显示,两组患者性别、吸烟史、心绞痛史、糖尿病史、高脂血症史及高血压史的比较,差异无统计学意义(P>0.05),但死亡组年龄≥60岁的比例、伴有早发冠心病、自身免疫疾病及慢性阻塞性肺疾病的比例较存活组均明显升高(P<0.05);两组患者总胆固醇、甘油三酯、血清钾、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及左心室射血分数(LVEF)的比较差异无统计学意义(P>0.05),但死亡组脑钠肽和C反应蛋白水平较存活组明显升高(P<0.05)。多因素Logistic回归分析显示,年龄、伴有自身免疫疾病、慢性阻塞性肺疾病、早发冠心病及血清C反应蛋白浓度是影响急性心肌梗死患者生存状况的相关因素(OR=1.38~4.76,P<0.05)。结论急性心肌梗死患者行PCI后1年的生存状况与患者年龄、伴有自身免疫疾病、慢性阻塞性肺疾病、早发冠心病及血清C反应蛋白水平密切相关,因此对伴有上述基础疾病者应积极进行干预和对症治疗以有效改善患者预后,提高生存质量。

Objective To analyze the 1-year survival and related factors of patients with acute myocardial infarction after percutaneous coronary intervention.Methods 170 patients with acute myocardial infarction admitted to our hospital were selected as the research object,and their clinical data were retrospectively analyzed.According to the 1-year survival after operation,they were divided into death group and survival group.The clinical data and laboratory examination indexes of the two groups were compared.The influencing factors of survival status of patients one year after operation were analyzed by single factor and multi-factor logistic regression.Results Of 170 patients,12 cases(7.06%)died one year after operation and 158 cases(92.94%)survived.Univariate analysis showed that there was no significant difference in sex,smoking history,angina pectoris history,diabetes mellitus history,hyperlipidemia history and hypertension history between the two groups(P>0.05),but the proportion of age(≥60 years old),early coronary heart disease,autoimmune disease and chronic obstructive pulmonary disease in the death group was significantly higher than that in the survival group(P<0.05).There was no significant difference in serum cholesterol,triglyceride,potassium,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and left ventricular ejection fraction(LVEF)(P>0.05),but the levels of brain natriuretic peptide and C-reactive protein in the death group were significantly higher than those in the survival group(P<0.05).Multivariate logistic regression analysis showed that age,autoimmune diseases,chronic obstructive pulmonary disease,early coronary heart disease and serum C-reactive protein concentration were related factors affecting the survival of patients with acute myocardial infarction(P<0.05).Conclusions The 1-year survival of patients with acute myocardial infarction after percutaneous coronary intervention is closely related to age,autoimmune diseases,chronic obstructive pulmonary disease,early onset coronary heart disease and serum C-reactive protein concentration.Therefore,patients with these basic diseases should be actively intervened and symptomatic treated to effectively improve the prognosis and quality of life.