急性前壁心肌梗死急诊介入治疗患者住院期间心力衰竭原因的分析

目的探讨急性前壁ST段抬高心肌梗死患者行急诊PCI后,发生心力衰竭的危险因素。方法回顾性研究初诊为急性前壁ST段抬高心肌梗死、并行急诊PCI的110例患者,根据是否有心力衰竭,分为心力衰竭组39例和非心力衰竭组71例,比较2组患者临床基础特征,应用logistic回归分析心力衰竭的危险因素。结果心力衰竭组与非心力衰竭组患者年龄、高血压、糖尿病、梗死前心绞痛、发病至手术时间、收缩压、入院血糖、白细胞计数、B型钠尿肽、β受体阻滞剂、术后TIMI血流比较,差异均有统计学意义(P<0.05,P<0.01)。发病至手术时间、年龄、入院血糖、高血压为心力衰竭的危险因素;梗死前心绞痛、术后TIMI血流为心力衰竭的保护因素。结论发病时间长、年龄大,血糖、血压等危险因素越多,术后TIMI血流差,患者心力衰竭的可能性越高。

Risk factors for heart failure in patients with acute anterior myocardial infarction after PCI

Objective To study the risk factors for heart failure(HF)in patients with acute anterior myocardial infarction after PCI.Methods Clinical data about 110patients with ST-elevated acute anterior myocardial infarction after PCI were retrospectively analyzed.The patients were divided into HF group(n=39)and non-HF group(n=71).Their clinical baseline characteristics were compared.The risk factors for their HF were analyzed by logistic regression analysis.Results Significant differences were found in age,hypertension,diabetes mellitus,pre-infarction angina pectoris,time from symptom onset to operation,systolic pressure,blood glucose at admission, white blood cells,BNP level,β-receptor blocker level and post-operative TIMI flow between the two groups(P<0.05,P<0.01).Time from symptom onset to operation,age,blood glucose at admission and hypertension were the risk factors for HF(P<0.05).Pre-infarction angina pectoris and post-operative TIMI flow were its protection factors.Conclusion The more the risk factors for HF(including the disease onset time,age,blood glucose and hypertension)are,the poorer the post-operative TIMI flow is,the easier the HF occurs in patients with acute anterior myocardial infarction after PCI.