急性ST段抬高心肌梗死并发心力衰竭的相关因素研究

Related Factors of Acute ST Segment Elevation Myocardial Infarction Complicated with Heart Failure

目的:分析急性ST段抬高心肌梗死(STEMI)的临床特征,探讨并发心力衰竭的危险因素。方法:选取2017年1月-2019年12月本院收治的103例急性STEMI患者,依据入院Killip分级,将38例合并心衰者(KillipⅡ~Ⅳ级)作为试验组,65例心功能正常者作为对照组(KillipⅠ级)。采集两组临床资料,logistic回归分析急性STEMI合并心衰的危险因素。结果:两组年龄、入院收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、白细胞计数(WBC)、血红蛋白(HGB)、左室射血分数(LVEF)及冠脉病变支数比较,差异均有统计学意义(P<0.05)。单因素回归分析结果显示,年龄、DBP、FPG、HGB、LVEF为急性STEMI患者并发心衰的相关因素(P<0.05)。多因素回归分析结果显示,年龄、DBP、HGB及LVEF为急性STEMI并发心衰的独立危险因素。结论:急性STEMI合并心衰是多因素共同作用的临床结局,其中年龄、DBP、HGB及LVEF是急性STEMI并发心衰的独立危险因素,具有重要的预测价值。

Objective:To analyze the clinical features of acute ST-segment elevation myocardial infarction(STEMI)and to explore the risk factors of complicated heart failure.Method:A total of 103 patients with acute STEMI admitted to our hospital from January 2017 to December 2019 were selected.According to the admission Killip classification,38 patients with heart failure(KillipⅡ-Ⅳ)were selected as the experimental group,and 65 patients with normal heart function(KillipⅠ)were selected as the control group.The clinical data of the two groups were collected,and the risk factors of acute STEMI complicated with heart failure were analyzed by logistic regression.Result:There were significant differences in age,SBP,DBP,FPG,WBC,HGB,LVEF and the number of coronary artery lesions between the two groups(P<0.05).Univariate regression analysis showed that age,DBP,FPG,HGB and LVEF were related factors of acute STEMI patients complicated with heart failure(P<0.05).Multivariate regression analysis showed that age,DBP,HGB and LVEF were independent risk factors of acute STEMI complicated with heart failure.Conclusion:Acute STEMI complicated with heart failure is the clinical outcome of multiple factors,among which age,DBP,HGB and LVEF are independent risk factors for acute STEMI complicated with heart failure,and have important predictive value.