急性心肌梗死患者急诊PCI后消化道出血的危险因素分析

Risk factors of gastrointestinal bleeding after emergency PCI in patients with acute myocardial infarction

目的探讨急性心肌梗死患者行急诊冠状动脉介入术(PCI)后消化道出血的危险因素。方法抽取2010年1月至2019年12月于商丘市第一人民医院行急诊PCI治疗的心肌梗死患者3350例,回顾性分析其病历资料,统计消化道出血及住院期间不良事件发生情况,应用Logistic回归分析消化道出血的危险因素。结果行急诊PCI治疗的3350例心肌梗死患者发生消化道出血105例,占3.1%。Logistic回归分析结果示,高龄OR=2.181、P=0.019,贫血OR=8.976、P=0.001,既往消化道溃疡病史OR=1.093、P=0.043,慢性肾功能不全OR=3.776、P=0.046,三联抗血小板治疗OR=3.619、P=0.017。消化道出血者死亡8例,输血5例。结论高龄、贫血、既往消化道溃疡史、慢性肾功能不全、三联抗血小板治疗是急性心肌梗死患者行急诊PCI后消化道出血的危险因素,消化道出血可影响患者预后。

Objective To investigate the risk factors of gastrointestinal bleeding after emergency percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods A total of 3350 patients with myocardial infarction who underwent emergency PCI treatment in Shangqiu First People’s Hospital from January 2010 to December 2019 were sellected,and their medical records were retrospectively analyzed.The gastrointestinal bleeding and adverse events during hospitalization were counted.Logistic regression analysis was used to analyze the risk factors of gastrointestinal bleeding.Results There were 105 cases of gastrointestinal bleeding occurred in 3350 patients with myocardial infarction who underwent emergency PCI treatment,accounting for 3.1%.Logistic regression analysis results showed that the elderly age OR=2.181,P=0.019,anemia OR=8.976,P=0.001,previous history of peptic ulcer OR=1.093,P=0.043,chronic renal insufficiency OR=3.776,P=0.046,triple anti for platelet therapy OR=3.619,P=0.017.Eight cases of gastrointestinal bleeding died and 5 cases of transfusion.Conclusions Elderly age,anemia,previous history of peptic ulcer,chronic renal insufficiency,and triple antiplatelet therapy are risk factors of gastrointestinal hemorrhage after emergency PCI in patients with acute myocardial infarction,and gastrointestinal hemorrhage can affect the prognosis of patients.