行主动脉内球囊反搏治疗的心肌梗死患者生存率的影响因素
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摘要
目的分析行主动脉内球囊反搏(IABP)治疗的心肌梗死患者生存率的影响因素。方法选取行IABP治疗的心肌梗死患者94例。根据患者存活状况分为存活组与死亡组。比较2组患者临床基本情况、冠状动脉造影结果和急诊PCI结果,并对相关因素进行多因素回归分析。结果 2组患者平均年龄、KillipsⅢ/Ⅳ例患者比例、CK-MB峰值比较,差异有统计学意义(P<0.05)。2组发生合并LM病变、PCI后TIMI3级血流患者比例比较,差异有统计学意义(P<0.05)。多因素回归分析显示,患者年龄、KillipsⅢ/Ⅳ级、CK-MB峰值、PCI后TIMI3级血流、合并LM病变均为影响患者生存状况的危险因素。结论IABP治疗后的心肌梗死患者生存状况受患者年龄、KillipsⅢ/Ⅳ级、CK-MB峰值、PCI后TIMI3级血流、合并LM病变等因素的影响。
Objective To investigate the influencing factors of survival rate in patients with myocardial infarction treated with intra-aortic balloon pump( IABP). Methods A total of 94 myocardial infarction patients with IABP in our hospital were selected,and were divided into survival group and death group according to the survival status. Clinical data,results of coronary angiography,emergency PCI results were compared,and the relevant influencing factors were analyzed by multivariate regression analysis. Results The average age,ratio of Killips III/IV,CK-MB peak showed significant differences between two groups( P < 0. 05). Significant differences were seen in the proportion of patients merging LM disease and blood flow with class TIMI3 after PCI in the two groups( P <0. 05). Multivariate regression analysis showed that the age,Killips III/IV,CK-MB peak,blood flow with class TIMI3 after PCI,and merging LM lesions were the risk factors of survival status for patients. Conclusion The survival status of patients with IABP are mainly influenced by age,Killips III/IV,CK-MB peak,blood flow with class TIMI3 after PCI,and merging LM lesions and other factors.
Objective To investigate the influencing factors of survival rate in patients with myocardial infarction treated with intra-aortic balloon pump( IABP). Methods A total of 94 myocardial infarction patients with IABP in our hospital were selected,and were divided into survival group and death group according to the survival status. Clinical data,results of coronary angiography,emergency PCI results were compared,and the relevant influencing factors were analyzed by multivariate regression analysis. Results The average age,ratio of Killips III/IV,CK-MB peak showed significant differences between two groups( P < 0. 05). Significant differences were seen in the proportion of patients merging LM disease and blood flow with class TIMI3 after PCI in the two groups( P <0. 05). Multivariate regression analysis showed that the age,Killips III/IV,CK-MB peak,blood flow with class TIMI3 after PCI,and merging LM lesions were the risk factors of survival status for patients. Conclusion The survival status of patients with IABP are mainly influenced by age,Killips III/IV,CK-MB peak,blood flow with class TIMI3 after PCI,and merging LM lesions and other factors.
引文
[1]Alam M.Comparison by meta-analysis of percutaneous coronary intervention versus coronary artery bypass graft ing in patients with a mean age of≥70 years[J].Am J Cardiol,2013,112(5):615-622.
[2]Raposeiras-Roubín S.GRA CE risk score predicts contrast-induced nephropathy in patients with acute coronary syndrome and normal renal function[J].Angiology,2013,64(1):31-39.
[3]傅庆华,郑昭芬.IABP辅助治疗对急性ST段抬高型心肌梗死合并重度心衰患者预后的影响[J].医学临床研究,2016,33(4):758-760.
[4]周婷,周莲等.急性心肌梗死IABP植入术后的临床护理[J].西部医学,2014,26(3):373-374,377.
[5]栾丽娟,王兴莉.主动脉内球囊反搏术在老年急性心肌梗死合并心源性休克患者中的应用[J].中华老年医学杂志,2014,33(11):1164-1166.
[6]沈鑫,余小林.主动脉内球囊反搏在急性广泛前壁心肌梗死急诊介入治疗中的应用[J].中国医师进修杂志,2015,38(10):770-772
[7]冯春光,付强.主动脉球囊反搏对再灌注不良的急性前壁心肌梗死患者血浆脑钠素和心功能的影响[J].中国全科医学,2013,16(1):43-46.
[8]张贤锐,苏立.主动脉球囊反搏辅助治疗急性心肌梗死患者疗效评价[J].中华心血管病杂志,2013,41(5):432-437.
[9]洪泰连,徐凯.主动脉内球囊反搏对急性ST段抬高型心肌梗死患者死亡率的影响[J].解放军医学杂志,2016,41(6):441-445.
[10]崔锦钢,吴元.主动脉内球囊反搏在急性冠状动脉综合征治疗中的临床应用[J].中国循环杂志,2015,29(2):107-110.
[11]潘宏伟,郑昭芬.急诊IABP循环支持脱机时间对AMI并泵衰竭患者心功能的影响[J].临床误诊误治,2016,29(6):40-43.
[12]李正章,程石.不同时间窗冠状动脉介入治疗对急性ST段抬高心肌梗死患者左室功能及远期预后的影响[J].湖南师范大学学报:医学版,2015,11(6):61-63.
[13]Jiang C Y,Zhao L L,Wang J A,et al.Anticoagulation therapy in intra-aortic balloon counterpulsation:does IABP really need anti-coagulation[J].J Zhejiang Univ Sci,2013,4(5):607-611.
[14]高志伟,黄英姿.主动脉内球囊反搏对接受不同血管重建急性心肌梗死患者预后影响的荟萃分析[J].中华心血管病杂志,2016,44(7):588-593.
[15]Boersma E,Harrington R A,Moliterno D J,et al.Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes:a meta-analysis of all major randomised clinical trials[J].Lancet,2012,359(9302):189-198.
[16]任玉娇.全程精细化优质护理模式应用于急性广泛前壁心肌梗死患者行IABP术后护理的体会[J].实用临床医药杂志,2014,04:65-67.
[17]潘敏,李本玲,喻贤珍.急性心肌梗死患者行主动脉内球囊反搏术的护理[J].实用临床医药杂志,2013,20:15
[18]范羽飞,常芸,宋萍.1例急性心肌梗死合并室间隔穿孔行主动脉球囊反搏患者的护理[J].实用临床医药杂志,2015,02:144-145,148.
[2]Raposeiras-Roubín S.GRA CE risk score predicts contrast-induced nephropathy in patients with acute coronary syndrome and normal renal function[J].Angiology,2013,64(1):31-39.
[3]傅庆华,郑昭芬.IABP辅助治疗对急性ST段抬高型心肌梗死合并重度心衰患者预后的影响[J].医学临床研究,2016,33(4):758-760.
[4]周婷,周莲等.急性心肌梗死IABP植入术后的临床护理[J].西部医学,2014,26(3):373-374,377.
[5]栾丽娟,王兴莉.主动脉内球囊反搏术在老年急性心肌梗死合并心源性休克患者中的应用[J].中华老年医学杂志,2014,33(11):1164-1166.
[6]沈鑫,余小林.主动脉内球囊反搏在急性广泛前壁心肌梗死急诊介入治疗中的应用[J].中国医师进修杂志,2015,38(10):770-772
[7]冯春光,付强.主动脉球囊反搏对再灌注不良的急性前壁心肌梗死患者血浆脑钠素和心功能的影响[J].中国全科医学,2013,16(1):43-46.
[8]张贤锐,苏立.主动脉球囊反搏辅助治疗急性心肌梗死患者疗效评价[J].中华心血管病杂志,2013,41(5):432-437.
[9]洪泰连,徐凯.主动脉内球囊反搏对急性ST段抬高型心肌梗死患者死亡率的影响[J].解放军医学杂志,2016,41(6):441-445.
[10]崔锦钢,吴元.主动脉内球囊反搏在急性冠状动脉综合征治疗中的临床应用[J].中国循环杂志,2015,29(2):107-110.
[11]潘宏伟,郑昭芬.急诊IABP循环支持脱机时间对AMI并泵衰竭患者心功能的影响[J].临床误诊误治,2016,29(6):40-43.
[12]李正章,程石.不同时间窗冠状动脉介入治疗对急性ST段抬高心肌梗死患者左室功能及远期预后的影响[J].湖南师范大学学报:医学版,2015,11(6):61-63.
[13]Jiang C Y,Zhao L L,Wang J A,et al.Anticoagulation therapy in intra-aortic balloon counterpulsation:does IABP really need anti-coagulation[J].J Zhejiang Univ Sci,2013,4(5):607-611.
[14]高志伟,黄英姿.主动脉内球囊反搏对接受不同血管重建急性心肌梗死患者预后影响的荟萃分析[J].中华心血管病杂志,2016,44(7):588-593.
[15]Boersma E,Harrington R A,Moliterno D J,et al.Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes:a meta-analysis of all major randomised clinical trials[J].Lancet,2012,359(9302):189-198.
[16]任玉娇.全程精细化优质护理模式应用于急性广泛前壁心肌梗死患者行IABP术后护理的体会[J].实用临床医药杂志,2014,04:65-67.
[17]潘敏,李本玲,喻贤珍.急性心肌梗死患者行主动脉内球囊反搏术的护理[J].实用临床医药杂志,2013,20:15
[18]范羽飞,常芸,宋萍.1例急性心肌梗死合并室间隔穿孔行主动脉球囊反搏患者的护理[J].实用临床医药杂志,2015,02:144-145,148.