急诊PCI治疗急性心肌梗死患者的预后影响因素分析

摘要

Objective To detect the prognostic factors of acute myocardial infarction(AMI)patients with emergency PCI treatment. Methods A total of 1489 patients with AMI were enrolled. A retrospective analysis was used to analyze their medical records and factors affected the prognosis. Results The ratio of AMI combined with COPD, autoimmune disease and premature coronary heart disease in death group was higher than that in survival group The AMI patients in death group had a higher serum level of CRP and NT-proBNP than those in surviral group had. The Logistic regression analysis revealed that older age,elevated CRP, patients with premature coronary heart disease,AMI combined with COPD and autoimmune disease were risk factors for AMI patients death in 1 year period. Conclusion The patients with premature coronary heart disease or combined with COPD or autoimmune disease should be taken active treatment for ameliorating the prognosis.%目的 分析急性心肌梗死(acute myocardial infarction,AMI)患者行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗术后预后的影响因素.方法 回顾性分析行急诊PCI治疗的1489例AMI患者的病历资料,根据术后随访1年患者的生存状况,分为存活组(1424例)和死亡组(65例),比较两组患者的临床资料和实验室指标,并分析影响预后的因素.结果1489例AMI患者中,死亡组患者合并慢性阻塞性肺疾病(COPD)、自身免疫病及早发冠心病的比例均高于存活组(P均=0.000),死亡组患者的年龄、血清C反应蛋白(CRP)及N端B型脑钠肽前体(NT-proBNP)水平均高于存活组(P均=0.000).多因素Logistic回归结果显示,AMI患者的年龄越大、血清CRP水平升高、早发冠心病、合并COPD及自身免疫病是其预后不良的危险因素.结论 对于早发冠心病、合并COPD及自身免疫病的AMI患者应积极治疗基础疾病,可改善预后.