创伤失血性休克发生2型心肌梗死的相关因素分析

Influencing factors related to type 2 myocardial infarction in patients with traumatic hemorrhagic shock

目的探讨创伤失血性休克患者发生2型心肌梗死(T2MI)的相关因素。方法统计109例创伤失血性休克患者的临床数据,判断是否发生T2MI,采用单因素分析及logistic多因素分析,得出发生T2MI的独立危险因素。结果单因素分析显示,创伤失血性休克患者发生T2MI与年龄(χ^2=4.883,P=0.027)、收缩压(χ^2=9.160,P=0.002)、房颤(χ^2=4.576,P=0.032)、既往高血压史(χ^2=4.320,P=0.038)和心力衰竭(χ^2=4.813,P=0.028)有关。多因素分析显示,年龄≥60岁、收缩压<60mmHg和心力衰竭是其独立危险因素。结论在临床诊治中,创伤失血性休克患者不仅需要维持生命器官的灌注并迅速恢复组织灌注,还应保护各脏器的功能,尤其应注意T2MI的发生。

Objective To evaluate influencing factors related to type 2 myocardial infarction in patients with traumatic hemorrhagic shock.Methods Clinical data of 109 patients with traumatic hemorrhagic shock were collected,and incidence type 2 myocardial infarction was documented.Univariate analysis and multivariate logistic analysis was used to investigate the risk factors of type 2myocardial infarction in traumatic hemorrhagic shock patients.Results Univariate analysis showed that type 2 myocardial infarction in patients with traumatic hemorrhagic shock was related with age(X^2=4.883,P=0.027),systolic pressure(x^2=9.160,P=0.002),atrial fibrillation(x^2=4.576,P=0.032),hypertension history(x^2=4.320,P=0.038)and cardiac failure(x^2=4.813,P=0.028).Multivariate analysis revealed that age over 60,systolic pressure below 60mmHg and cardiac failure were the independent risk factors.Conclusion For traumatic hemorrhagic shock patients it is necessary to quickly restore and maintain organ and tissue perfusion,also need to protect the function of various organs,especially the occurrence of type 2 myocardial infarction should be considered.