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目的探讨急性ST段抬高性心肌梗死后发生心力衰竭的危险因素。方法入选急性ST段抬高性心肌梗死患者,根据心功能情况分为心功能正常组及心功能减低组。比较两组患者临床资料、冠脉危险因素、冠脉造影结果和直接PCI结果,采用logistic回归分析影响住院期间死亡的危险因素。结果心肌梗死后发生心功能衰竭者发病年龄大,女性比例高,有陈旧性心肌梗死病史者比例高。心功能减低组接受主动脉内球囊反搏泵(intra-aortic balloonpump,IABP)植入治疗者比例高。多因素回归分析结果提示,肾功能不全和心功能降低是导致住院期间死亡的独立预测因素。结论急性心肌梗死合并心血管高危因素越多,年龄大,且未能接受介入检查和治疗患者易发生心功能衰竭。肾功能不全、心功能降低的急性ST段抬高性心肌梗死患者住院期间死亡风险明显升高。
Objective To investigate the risk factors of heart failure after acute ST-segment elevation myocardial infarction. Methods Selected patients with acute ST-elevation myocardial infarction, according to cardiac function is divided into normal cardiac function group and cardiac dysfunction group. The clinical data, coronary risk factors, coronary angiography results and direct PCI results were compared between the two groups. Logistic regression analysis was used to analyze the risk factors influencing in-hospital mortality. Results of heart failure patients after myocardial infarction onset age, high proportion of women with a history of old myocardial infarction, a high proportion. Patients with impaired cardiac function received a high percentage of intra-aortic balloon pump (IABP) implants. Multivariate regression analysis showed that renal insufficiency and impaired cardiac function were independent predictors of death during hospitalization. Conclusion Acute myocardial infarction with cardiovascular risk factors, older, and failed to accept interventional examination and treatment of patients prone to heart failure. Renal insufficiency, impaired cardiac function in patients with acute ST-elevation myocardial infarction significantly increased the risk of death during hospitalization.