摘要
目的分析心电图相关导联ST段抬高总和降幅(sum-ST-segment resolution,ΣSTR)与ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)预后的相关性。方法回顾性分析2018年1月~2021年1月我院收治的120例STEMI患者的临床资料,所有患者均行PCI术治疗。根据患者预后情况分为预后良好组72例,预后不良组48例。比较两组患者基础资料、既往病史、Killip心功能分级、实验室检查结果及心电图检查结果。通过受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析直接胆红素(direct bilirubin,DBil)预测STEMI患者PCI术预后不良的价值。通过多因素Logistic回归分析明确STEMI患者PCI术预后不良的危险因素。结果120例患者出院后均行1年随访,其中48例(40.00%)患者预后不良,72例(60.00%)预后良好。预后不良组中存在糖尿病史、Killip心功能分级Ⅲ~Ⅳ级、ΣSTR<50%例数占比高于预后良好组,预后不良组DBil水平高于预后良好组(P<0.05)。经ROC分析证实,DBil可用于预测STEMI患者PCI术预后不良,曲线下面积为0.733,P<0.05。多因素Logistic回归分析显示,有糖尿病史、Killip心功能分级Ⅲ~Ⅳ级、DBil>5.470μmol/L、ΣSTR<50%是STEMI患者PCI术预后不良的危险因素(P<0.05)。结论STEMI患者PCI术预后受糖尿病史、Killip心功能分级、DBil水平、ΣSTR等因素影响,以上因素均为预后不良的危险因素,需引起临床重视。
Objective To analyze the correlation between the sum-ST-segment resolution(ΣSTR)in ECG related leads and the prognosis of percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods The clinical data of 120 patients with STEMI admitted to our hospital from January 2018 to January 2021 were analyzed retrospectively.The patients were divided into good prognosis group(n=72)and poor prognosis group(n=48).All patients underwent PCI.The basic data,past medical history,Killip cardiac function grading,laboratory examination results and ECG examination results of the two groups were compared.The value of direct bilirubin(DBil)in predicting the poor prognosis of PCI in STEMI patients by receiver operating characteristic(ROC)analysis.The risk factors for poor prognosis of PCI in STEMI patients were identified by multivariate Logistic regression analysis.Results A total of 120 patients were followed up for one year after discharge,of which 48(40.00%)had a poor prognosis and 72(60.00%)had a good prognosis.In the poor prognosis group,the proportion of patients with history of diabetes,Killip cardiac function gradeⅢ~Ⅳ,ΣSTR<50%were higher than those of patients with good prognosis,and the level of DBil in patients with poor prognosis was higher than that in patients with good prognosis(P<0.05).ROC analysis confirmed that DBil can be used to predict the poor prognosis of PCI in STEMI patients.The area under the curve was 0.733,and P<0.05.Multivariate Logistic regression analysis showed that patients with history of diabetes,Killip’s cardiac function gradeⅢ~Ⅳ,DBiL>5.470μmol/L,ΣSTR<50%were risk factors for poor prognosis of STEMI patients after PCI(P<0.05).Conclusion The prognosis of PCI in STEMI patients are affected by the history of diabetes,Killip cardiac function classification,DBiL levelΣSTR and other factors,when Killip cardiac function is gradeⅢ~Ⅳ,DBiL>5.470μmol/L,ΣSTR<50%are risk factors for poor prognosis,which should be pay attention to clinic.
作者
刘荣
胡茜
李亚楠
LIU Rong;HU Qian;LI Ya-nan(Cardiogram Room,The Third People’s Hospital of Bengbu City,Bengbu 233000,China;Department of Cardiology,The Third People’s Hospital of Bengbu City,Bengbu 233000,China)
出处
《哈尔滨医科大学学报》
CAS
2023年第2期192-196,共5页
Journal of Harbin Medical University
基金
安徽省自然科学基金面上项目(1908085MC90)
