急性心肌梗死并发心力衰竭的临床特征及危险因素分析

Clinical features and risk factors of acute myocardial infarction complicated by heart failure

目的探讨急性心肌梗死并发心力衰竭的临床特征及危险因素。方法选择2021年6月至2024年6月于山东第一医科大学附属省立医院收治的222例急性心肌梗死患者进行研究,根据并发心力衰竭分为并发心力衰竭组(n=97)和对照组(n=125)。收集两组患者的临床资料,比较并分析急性心肌梗死并发心力衰竭的临床特点,采用多因素非条件Logistic回归模型分析急性心肌梗死并发心力衰竭的危险因素。结果两组年龄、性别、糖尿病、心房颤动、血红蛋白、肌酐、肌钙蛋白、D-二聚体、Gensini评分水平比较,差异有统计学意义(P<0.05);两组高血压、血小板计数、胆固醇水平比较,无显著差异(P>0.05)。单因素分析结果显示,两组在性别、年龄、收缩压、舒张压、心率、脑钠肽(BNP)、左室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、治疗方式比较有差异(P<0.05);两组体质量指数(BMI)、吸烟史、饮酒史、既往史、肌钙蛋白I(cTnI)及病变支数水平比较无显著差异(P>0.05)。多因素非条件Logistic回归分析显示,性别、年龄、收缩压、舒张压、心率、BNP、LVEDD、LVESD、LVEF、治疗方式均是急性心肌梗死患者并发心力衰竭的独立危险因素(P<0.05)。结论急性心肌梗死并发心力衰竭的危险因素较多,针对危险因素及时治疗,可提高患者生活质量。

Objective To discuss the clinical features and risk factors of acute myocardial infarction(AMI)complicated by heart failure(HF).Methods AMI patients(n=222)were chosen and divided,according to complicated HF status,into HF group(n=97)and control group(n=125)from Provincial Hospital of Shandong Province affiliated to Shandong First Medical University from June 2021 to June 2024.The clinical materials were collected in 2 groups,and clinical features of AMI complicated by HF were compare and analyzed.The risk factors of AMI complicated by HF were analyzed by using multi-factor Logistic regression model.Results The differences in age,gender,diabetes,atrial fibrillation(AF),hemoglobin(Hb),creatinine(Cr),cardiac troponin,D-dimer(D-D)and Gensini scores had statistical significance between 2 groups(P<0.05).The differences in hypertension,platelet count(PLT)and cholesterol level had no statistical significance between 2 groups(P>0.05).The results of single-factor analysis showed that the differences in gender,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),brain natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)and therapies had statistical significance between 2 groups(P<0.05).The differences in body mass index(BMI),history of smoking and drinking,past medical history,cardiac troponin I(cTnI)and number of diseased vessels had no statistical significance between 2 groups(P>0.05).The results of multi-factor non-conditional Logistic regression analysis showed that gender,age,SBP,DBP,HR,BNP,LVEDD,LVESD,LVEF and therapies were independent risk factors in patients with AMI complicated by HF(P<0.05).Conclusion There are many risk factors for AMI complicated by HF,and timely treatment should be targeted at these risk factors to improve quality of life in the patients.