ST段抬高型心肌梗死并心源性休克患者经IABP联合PCI治疗预后的影响因素分析

Analysis of influencing factors of prognosis of patients with ST-segment elevation myocardial infarction and cardiogenic shock treated with IABP and PCI

目的分析影响ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)并心源性休克(Cardiogenic shock,CS)患者经主动脉内球囊反搏(Intra-aortic ballon pump,IABP)联合冠状动脉介入术(Percutaneous coronary intervention,PCI)治疗预后的影响因素。方法选择2018年11月至2019年11月本院收治的STEMI并CS患者80例作为研究对象,均经IABP联合PCI治疗,术后随访3个月,根据预后情况进行分组,将病死、冠状动脉造影下血流等级(TIMI)<2级患者归为预后不良组(n=24),另56例为预后良好组。记录患者一般资料、治疗情况等,分析影响STEMI并CS患者经IABP联合PCI治疗预后的影响因素。结果预后不良组吸烟史占比、冠状动脉三支病变及术后TIMI 1级占比均高于预后良好组,差异有统计学意义(P<0.05);经多项Logistic回归分析检验,吸烟史、冠状动脉三支病变、术后TIMI 1级是影响STEMI并CS患者经IABP联合PCI治疗后预后不良的危险因素(OR>1,P<0.05)。结论吸烟史、冠状动脉三支病变、术后TIMI 1级是导致STEMI并CS患者经IABP联合PCI治疗后预后不良的危险因素,需采取相关措施进行预防。

Objective To analyze the influencing factors on the prognosis of patients with ST-segment elevation myocardial infarction(STEMI)and cardiogenic shock(CS)treated by intra-aortic balloon pump(IABP)and percutaneous coronary intervention(PCI).Methods A total of 80 patients with STEMI and CS admitted to our hospital from November 2018 to November 2019 were selected as the subjects.They were all treated with IABP and PCI,followed up for 3 months after operation,and were grouped according to prognosis condition.Patients who were dead and whose TIMI were under 2 grade were classified as poor prognosis group(n=24),and the other 56 cases were classified as good prognosis group.The patient's general information,treatment status,etc.were analyzed,and the influencing factors that affected the prognosis of patients after IABP and PCI treatment were anaylzed.Results The proportion of smoking history,three coronary artery lesions and 1 grade of postoperative TIMI in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05);multiple logistic regression analysis showed that smoking history,three coronary artery lesions,and 1 grade of postoperative TIMI were the risk factors for poor prognosis after IABP and PCI treatment in STEMI patients(OR>1,P<0.05).Conclusion Smoking history,three coronary artery lesions,and 1 grade of postoperative TIMI are the risk factors for poor prognosis after IABP combined with PCI in patients with STEMI and CS.Relevant measures should be taken to prevent it.