急性心肌梗死患者住院期间发生心力衰竭的影响因素分析

Analysis of Influencing Factors of Heart Failure in Patients with Acute Myocardial Infarction During Hospitalization

目的探讨急性心肌梗死(AMI)患者住院期间发生心力衰竭的影响因素。方法回顾性分析灵宝市第二人民医院2019年1月至2022年1月收治的100例AMI患者临床资料,分析AMI患者心力衰竭发生情况并收集患者临床资料进行单因素和多因素分析。结果100例AMI患者,行经皮冠状动脉介入术(PCI)后28例(28.00%)发生心力衰竭者,72例(72.00%)未发生心力衰竭者。两组年龄、病变血管数、氨基末端B型脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)、血红蛋白、左室射血分数(LVEF)比较,差异有统计学意义(P<0.05)。年龄65岁以上、多支病变血管数、高NT-proBNP水平、高hs-CRP水平、低血红蛋白水平、低LVEF均为AMI患者住院期间发生心力衰竭的独立危险因素,差异有统计学意义(OR=1.394、1.910、2.140、3.080、0.066、0.982,P<0.05)。结论AMI患者住院期间心力衰竭发生率较高,年龄65岁以上、多支病变血管数、高NT-proBNP水平、高hs-CRP水平、低血红蛋白水平、低LVEF均为相关影响因素,临床需针对上述危险因素给予患者针对性合理干预,降低心力衰竭发生率。

Objective To investigate the influencing factors of heart failure in patients with acute myocardial infarction(AMI)during hospitalization.Methods Clinical data of 100 patients with AMI admitted to our hospital from January 2019 to January 2022 were retrospectively analyzed.The incidence of heart failure in patients with AMI was analyzed and clinical data were collected for univariate and multivariate analysis.Result Among 100 patients with AMI,28(28.00%)developed heart failure after percutaneous coronary intervention(PCI),and 72(72.00%)did not.There were significant differences in age,number of diseased vessels,amino terminal B-type brain natriuretic peptide precursor(NT-proBNP),hypersensitive C-reactive protein(hs-CRP),hemoglobin and left ventricular ejection fraction(LVEF)between the two groups(P<0.05).Age over 65 years old,number of multi-vessel lesions,high NT-proBNP level,high hs-CRP level,low hemoglobin level and low LVEF were all independent risk factors for heart failure during hospitalization in AMI patients,and the difference was statistically significant(OR=1.394,1.910,2.140,3.080,0.066,0.982,P<0.05).Conclusion AMI patients have a high incidence of heart failure during hospitalization.Age over 65 years old,the number of multi-vessel lesions,high NT-proBNP level,high hs-CRP level,low hemoglobin level and low LVEF are all related influencing factors.Targeted and reasonable intervention should be given to these risk factors to reduce the incidence of heart failure.