| 单兴华 陈亮 李文文 汪 莹 陈启 余慧 秦永文 赵仙先.高龄 ST 段抬高心肌梗死患者经皮冠状动脉介入术后的院内预后及其影响因素分析[J].,2015,15(5):933-936 |
| 高龄 ST 段抬高心肌梗死患者经皮冠状动脉介入术后的院内预后及其影响因素分析 |
| Analysis of the In-hospital Prognosis of Very Elderly Patients with STEMIFollowing Primary PCI and its Influencing Factors |
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| DOI： |
| 中文关键词: 心肌梗死 经皮冠状动脉介入术 老年人 预后 危险因素 |
| 英文关键词: Myocardial Infarction Percutaneous Coronary Intervention Elderly Prognosis Risk Factors |
| 基金项目:国家自然科学基金项目（ 81 100197）； 长海医院 "1 255" 转化医学项目（ CH1 25550200） |
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| 中文摘要: |
| 目的： 探讨高龄 ST 段抬高心肌梗死(STEMI)患者行直接经皮冠状动脉介入(PCI)术后住院期间的预后情况及其影响因素。 方
法： 回顾性分析 2009 年 1 月 至 2013 年 12 月 因 STEMI 入住我院并行直接 PCI 的高龄患者(年龄≥ 75 岁 )的一般情况、既往史、入
院情况、术中及术后情况、并发症等资料， 总结分析该类患者住院期间 的临床预后， 并采用 logistic 回归模型对可能影响住院期间
主要不良心脏事件(MACE)的危险因素进行分析。 结果： 研究共纳入 127 例 患者，其中男性 84 例 (66.1 4%)， 女性 43 例 (33.86%)，年
龄 79± 3 岁， 住院时间 13.07± 7.80 天， 住院期间 MACE 的发生率为 1 7.32%，其中死亡 4 例 (3.15%)。 单因素 logistic 回归分析显示
入院时心功能(Killip 分级)≥ 2 级、完全性房室传导阻滞、窦性停搏与 高龄 STEMI 患者直接 PCI 术后住院期间 MACE 的发生相
关，具有统计学意义(P<0.05)。 而多 因素 logistic 回归分析显示入院时心功能(Killip 分级)和完全性房室传导阻滞是高龄 STEMI 患
者住院期间 MACE 的危险因素。 结论： 高龄 STEMI 患者接受直接 PCI 治疗总体安全，影响其住院期间 MACE 的危险因素包括心
功能不全和完全性房室传导阻滞。 |
| 英文摘要: |
| Objective:To explore the in-hospital prognosis of very elderly patients with ST-segment elevation myocardial
infarction (STEMI) following primary percutaneous coronary intervention (PCI) and its influencing factors.Methods:Elderly patients (≥
75 years old) with STEMI flowing primary PCI admitted in our hospital from January 2009 to December 2013 were slected for this study,
the general condition, medical history, hospitalized cases, intraoperative and postoperative condition and complications were
retrospectively analyzed. The clinical prognosis of these patients during hospitalization was summarized, and a logistic regression model
was used to analyze the risk factors of major adverse cardiac events (MACE) during hospitalization.Results:1 27 patients were enrolled
in this study, including 84 (66.1 4%) males and 43 (33.86%) females, aging 79± 3 years old, and the length of hospital stay was 1 3.07±
7.80 days. During hospitalization, the occurrence rate of MACE was 17.32%, including 4 cases (3.15%) of death. Single factor logistic
regression analysis showed that Killip class≥ 2, complete atrio-ventricular block (CAVB) and sinus arrest were associated with MACE
during hospitalization of very elderly STEMI patients after primary PCI (P<0.05). Multi-factor logistic regression analysis showed that
heart function (Killip classification) and CAVB were risk factors for in-hospital MACE of very elderly STEMI patients after primary PCI.Conclusion:Primary PCI was generally safe for very elderly STEMI patients, heart dysfunction and CAVB were risk factors for the
in-hospital MACE of these patients. |
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