| 赵世明,范蒙蒙.急诊经皮冠脉介入术后心肌内出血对 ST段抬高型心肌梗死预后的影响[J].安徽医药,2022,26(6):1218-1221. |
| 急诊经皮冠脉介入术后心肌内出血对 ST段抬高型心肌梗死预后的影响 |
| Effect of intramyocardial hemorrhage after emergency PCI on the prognosis of patients with ST-segment elevation myocardial infarction |
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| DOI：10.3969/j.issn.1009-6469.2022.06.038 |
| 中文关键词: ST段抬高型心肌梗死 经皮冠状动脉介入治疗 心肌内出血 心脏磁共振 |
| 英文关键词: ST elevation myocardial infarction Percutaneous coronary intervention Intramyocardial hemorrhage Cardiac magnetic resonance |
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| 中文摘要: |
| 目的分析 ST段抬高型心肌梗死( STEMI)急诊经皮冠脉介入术( PCI)后心肌内出血对病人预后的影响。方法回顾性收集 2016年 1月至 2020年 1月在平顶山市第二人民医院接受 PCI治疗的 STEMI病人 314例。收集病人入院时的基线资料、既往史、心脏磁共振检查结果及随访结束时病人的主要不良心脏事件( MACE)。根据病人是否发生 MACE将病人分为 MACE组 51例和非 MACE组 263例，比较两组间的临床特征，分析影响 STEMI病人死亡的独立危险因素，计算不同组间的生存率并比较。结果 MACE组和非 MACE组在 Killip分级、阻塞相关动脉、 TIMI危险评分、 PCI前 TIMI等级、左心室射血分数、梗死面积、微血管阻塞和心肌内出血间差异有统计学意义( P<0.05)。 Killip心功能分级、 PCI前 TIMI等级、梗死面积、微血管阻塞和心肌内出血为 STEMI病人出院后 1年内发生 MACE的独立危险因素。心肌内出血组 MACE发生率为 30.8%，明显高于无心肌内出血组 12.2%(P<0.001)。心肌内出血组全因死亡率为 19.1%，明显高于无心肌内出血组 6.1%(P=0.022)。结论 STEMI急诊 PCI术后心肌内出血是病人术后 1年内发生 MACE的独立危险因素，心肌内出血组 MACE的发生率高，生存率低。 |
| 英文摘要: |
| Objective To analyze the effect of intramyocardial hemorrhage after ST-segment elevation myocardial infarction (STEMI) emergency percutaneous coronary intervention (PCI) on the prognosis of patients.Methods A total of 314 STEMI patients who received PCI treatment in Pingdingshan Second People's Hospital from January 2016 to January 2020 were retrospectively collected. Thegeneral baseline data, past history, cardiac magnetic resonance examination results and the patient's major adverse cardiac events(MACE) at the end of the follow-up were collected. According to whether the patients had MACE or not, the patients were divided into MACE group and non-MACE group. Chi-square test or independent sample t test was used to compare the clinical characteristics between the two groups, logistic multivariate regression analysis of independent risk factors affecting death of STEMI patients, Keplan-Meier method to calculate survival rates between different groups, log-rank test was used to compare the survival rate of different groups.Results There were statistical differences between the death group and the survival group in Killip grade, occlusion related arteries, TIMI grade before PCI, infarct size, microvascular obstruction and intramyocardial hemorrhage (P<0.05). Killip cardiac functiongrade, TIMI grade before PCI, infarct size, microvascular obstruction, and intramyocardial hemorrhage were independent risk factors fordeath in STEMI patients within 1 year after discharge. The incidence of MACE in the intramyocardial hemorrhage group was 30.8%,which was significantly higher than 12.2% in the no intramyocardial hemorrhage group (P<0.001). The mortality rate in the intramyocardial hemorrhage group was 19.1%, which was significantly higher than 6.1% in the no intramyocardial hemorrhage group (P=0.022). Conclusion Intramyocardial bleeding after STEMI emergency PCI is an independent risk factor for MACE within 1 year after surgery. The incidence of MACE in the intramyocardial hemorrhage group is high and the survival rate is low. |
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