罪犯血管为右侧冠状动脉急性心肌梗死患者左心衰竭的危险因素分析

目的 探讨罪犯血管为右侧冠状动脉急性心肌梗死患者左心衰竭的危险因素。方法 选取2017年1月至2020年1月河南中医学院第一附属医院通过冠状动脉造影证实罪犯血管为右侧冠状动脉的急性心肌梗死患者550例,依据是否出现心力衰竭分组,分别为心力衰竭组（n=120）与非心力衰竭组（n=430）。分析两组基本资料、化验检查、病史、冠状动脉造影、治疗方案及并发症等情况,并予以对比,探索左心衰竭相关危险因素。结果 年龄、肌钙蛋白1（cTnI）与肌酸激酶同工酶（CK MB）最高值、急诊血运重建术后心电图ST段回落百分比、左前降支（LAD）病变、是否为右优势型、冠状动脉病变数目、择期血运重建、心律失常及心源性休克发生与否均为急性心肌梗死患者左心衰竭的危险因素（P＜0.05）。结论 罪犯血管为右侧冠状动脉急性心肌梗死患者入院后,掌握患者一般资料,及时评估cTnI与CK MB最高值、急诊血运重建术后心电图ST段回落百分比、LAD病变、是否为右优势型、冠状动脉病变数目、择期血运重建、心律失常及心源性休克发生与否,必要时及时采取对应措施,降低左心衰竭发生风险,改善患者预后,在临床治疗中具有重要意义。

Risk factors for left heart failure in patients with acute myocardial infarction and right coronary artery as culprit blood vessel

Objective To explore the risk factors for left heart failure in patients with acute myocardial infarction and right coronary artery as culprit blood vessel. Methods From January 2017 to January 2020, 550 patients with acute myocardial infarction and right coronary artery as culprit blood vessel confirmed by coronary angiography were selected from the First Affiliated Hospital of Henan University of Chinese Medicine. According to whether there was heart failure, they were divided into heart failure group (n=120) and non heart failure group (n=430). The basic information, laboratory tests, medical history, coronary angiography, treatment options, complications and other situations of two groups were analyzed and compared to explore the relevant risk factors of left heart failure. Results The risks factors for the left heart failure in patients with acute myocardial infarction included many factors, such as age, the highest value of cTnI and CK MB, percentage of ST segment resolution of ECG after emergency revascularization, LAD lesion, right dominant type, number of coronary artery lesions, selective revascularization, and the occurrence of arrhythmia and cardiogenic shock (P＜0.05). Conclusion After the hospital admission of patients with acute myocardial infarction and right coronary artery as culprit blood vessel, the general data of patients should be mastered in order to timely assess the highest values of cTnI and CK MB, the percentage of ST segment resolution in ECG after emergency revascularization, LAD lesions, whether the artery is right dominant, the number of coronary artery lesions, selective revascularization, and whether arrhythmia and cardiogenic shock occur. When necessary, timely response measures should be taken to reduce the risk of left heart failure and improve the prognosis of patients, which is of great significance in clinical treatment.