急性心肌梗死并发急性心力衰竭的相关因素分析

Relevant factor analysis of acute myocardial infarction complicated by acute heart failure

目的回顾性分析急性心肌梗死(acute myocardial infarction,AMI)并发急性心力衰竭(心衰)的相关因素。方法选取204例AMI患者,依据AMI后心衰Killip心功能分级分为心衰组(68例)和非心衰组(136例),根据临床数据及冠脉造影结果,分析患者住院期间发生AMI后早期心衰的概率、影响预后的基本因素。采用Logistic回归分析研究AMI患者产生早期心衰的危险因素及保护因素。结果心衰组与非心衰组的年龄、冠脉病变支数、梗死相关血管、中性粒细胞与淋巴细胞比值(NLR)、脑钠肽(BNP)、白蛋白差异均有统计学意义(P均<0.05);年龄、前降支病变、NLR、BNP是患者出现心衰的危险因素,而白蛋白是患者出现心衰的保护因素。结论患者体内NLR增大、BNP过高、年龄较大以及前降支病变可预测AMI患者出现急性心衰。

Objective To retrospectively analyze the relevant factors of acute myocardial infarction(AMI)complicated with acute heart failure(HF).Methods A total of 204 AMI patients treated in our hospital were selected as research objects.According to the Killip cardiac function classification of HF after AMI,they were divided into HF group(n=68)and non-HF group(NHF group,n=136).Based on clinical data and results of coronary angiography,the incidence of early HF after AMI in hospital and fundamental influencing factors of prognosis were analyzed.Logistic regression analysis was utilized to explore the risk and protective factors of early HF in AMI patients.Results There exist statistically significant differences of age,number of diseased coronary arteries,infarction-related vessels,neutrophils to lymphocytes ratio(NLR),brain natriuretic peptide(BNP)and albumin between HF and NHF groups(P<0.05).Age,lesions of anterior descending branch,NLR and BNP are risk factors of HF while albumin is a protective factor of HF.Conclusion High NLR and BNP level,older age,and lesions of anterior descending branch can predict acute HF in patients with AMI.