STEMI患者PCI并发心力衰竭的发生率及危险因素

Incidence Rate and Risk Factors of Heart Failure in STEMI Patients Undergoing PCI

目的调查ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)并发心力衰竭的发生率,并分析其危险因素。方法回顾性分析2016年8月至2019年5月于新乡市中心医院就诊的302例行PCI治疗的STEMI患者的临床资料。根据患者治疗期间是否出现心力衰竭,将患者分为心衰组和非心衰组。比较两组患者一般资料、入院时血压情况[平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)]、心脏超声检查[左房内径(LAD)、左室舒张末径(LVEDD)、右房内径(RAD)、右室舒张末径(RVEDD)]、实验室检查结果等资料差异。采用单因素及多因素logistic回归分析方程分析影响STEMI患者PCI并发心力衰竭的危险因素。结果302例STEMI首次接受PCI治疗的患者中,有95例患者并发心力衰竭,发生率为31.46%;年龄、室性心律失常、MAP、LAD、血红蛋白(Hb)、白细胞(WBC)、中性粒细胞计数(ANC)、C反应蛋白(CRP)、冠脉病变血管支数和冠脉病变部位是影响STEMI患者行PCI后并发心力衰竭的影响因素(P<0.05);经logistic回归分析显示,年龄、既往室性心律失常、MAP、LAD、Hb、冠脉病变部位为STEMI患者行PCI后并发心力衰竭的独立影响因素(P<0.05)。结论年龄、既往室性心律失常、MAP、LAD、Hb、冠脉病变部位为STEMI患者接受PCI后并发心力衰竭的独立影响因素,可采取针对性措施干预,降低发生风险。

Objective To investigate the incidence rate of heart failure in patients with ST-elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)and analyze its risk factors.Methods The clinical data of 302 STEMI patients who received PCI treatment in Xinxiang Central Hospital were retrospectively analyzed from August 2016 to September 2019.According to whether the patients developed heart failure during treatment,the patients were divided into heart failure group and non-heart failure group.The two groups of patients were compared in terms of baseline data,blood pressure status at admission[mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP)],cardiac ultrasound examination[left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),right atrial diameter(RAD),right ventricular end-diastolic diameter(RVEDD)]and laboratory examination results.Univariate analysis and multivariate logistic regression analysis equations were used to analyze the risk factors affecting heart failure in STEMI patients undergoing PCI.Results Among 302 STEMI patients who underwent PCI for the first time,95 patients were complicated with heart failure,with an incidence rate of 31.46%.Age,ventricular arrhythmia,MAP,LAD,haemoglobin(Hb),white blood cell(WBC),absolute neutrophil count(ANC),C-reactive protein(CRP),number of coronary artery diseased blood vessels and location of coronary artery lesion were the single factors that affected the heart failure after PCI in STEMI patients(P<0.05).Logistic regression analysis showed that age,previous ventricular arrhythmia,MAP,LAD,Hb and coronary artery lesion location were independent influencing factors for heart failure in STEMI patients after PCI(P<0.05).Conclusion Age,previous ventricular arrhythmia,MAP,LAD,Hb and coronary artery lesion location are independent influencing factors for heart failure in STEMI patients after PCI.It is necessary to take targeted intervention measures so as to reduce the risk.