ST段抬高型急性心肌梗死患者行PCI治疗近期预后影响因素分析

Analysis of Factors Influencing Short-term Prognosis in Patients with ST-segment Elevation Acute Myocardial Infarction After PCI

目的分析ST段抬高型急性心肌梗死(STEMI)患者行经皮冠状动脉介入(PCI)治疗的近期预后及影响因素。方法选取2018年9月-2020年12月收治的189例STEMI为研究对象,分析STEMI患者行PCI治疗的近期预后情况以及影响患者近期预后的危险因素。结果随访6个月,失访60例,实际随访129例。出院后短期无事件生存112例(86.82%)为预后良好组,出现不良心血管事件17例(13.18%)为预后不良组,其中新发急性心力衰竭8例、再次血运重建4例、恶性心律失常3例、顽固性心绞痛2例。预后良好组与预后不良组在年龄、吸烟史、术前胸痛持续时间、直接胆红素、心肌肌钙蛋白I及左心室射血分数(LVEF)方面比较差异均有统计学意义(P<0.05,P<0.01)。经多因素Logistic回归分析,年龄、吸烟史、术前胸痛持续时间、直接胆红素、心肌肌钙蛋白I及LVEF为影响STEMI患者行PCI治疗近期预后不良的独立危险因素(P<0.05,P<0.01)。结论STEMI患者的年龄、吸烟史、术前胸痛持续时间、直接胆红素、心肌肌钙蛋白I及LVEF均是影响PCI治疗近期预后不良的独立危险因素。

Objective To analyze the short-term prognosis and influencing factors of patients with ST-segment elevation acute myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 189 patients with STEMI treated from September 2018 to December 2020 were selected as the research subjects to analyze the short-term prognosis of STEMI patients after PCI and the risk factors affecting the short-term prognosis.Results After 6 months of follow-up,60 cases were lost to follow-up and 129 cases were followed up.After discharge,112 cases(86.82%)of short-term survival without events were set as the good prognosis group,and 17 cases(13.18%)of adverse cardiovascular events as the poor prognosis group,including 8 cases of new acute heart failure,4 cases of revasodilization,3 cases of malignant arrhythmia,and 2 cases of intractable angina pectoris.There were significant differences in age,smoking history,preoperative duration of chest pain,direct bilirubin,cardiac troponin I and left ventricular ejection fraction(LVEF)between the good prognosis group and the poor prognosis group(P<0.05,P<0.01).Multivariate Logistic regression analysis showed that age,smoking history,preoperative duration of chest pain,direct bilirubin,cardiac troponin I and LVEF were independent risk factors for poor short-term prognosis after PCI in STEMI patients(P<0.05,P<0.01).Conclusion Age,smoking history,preoperative duration of chest pain,direct bilirubin,cardiac troponin I,and LVEF were all independent risk factors for poor short-term outcome of STEMI patients after PCI.