急性心肌梗死患者冠脉介入术后住院期间MACCE及大出血的相关因素

    Relative factors for major adverse cardiac and cerebrovascular events or hemorrhage after percutaneous coronary intervention operation

      摘要
    • 摘要: 目的:回顾性分析急性心肌梗死（AMI）患者住院行冠状动脉介入(PCI)治疗术后发生主要不良心脑血管事件（MACCE）及大出血的相关因素。方法： 以2006年9月～2010年8月收住的280例AMI行PCI手术的患者为研究对象，分为病例组（包括MACCE组及大出血组）和对照组。搜集左室射血分数（LVEF）、血常规、血凝、肝肾功、血脂、血糖、心肌标志物等实验室数据以及球囊和支架扩张罪犯血管的部位、最高压力、时限、次数等指标，采用多因素Logistic回归的方法分析上述因素与MACCE及大出血的相关性。结果： 与手术相关的多因素Logistic回归分析显示支架扩张最高压力与MACCE具有相关性（P<0.01）；手术因素与大出血无任何相关。涵盖手术因素及实验室、病变及一般临床因素等多因素Logistic回归分析显示总胆固醇（TC）、心肌钙蛋白I(cTnI)、非弥漫性病变与MACCE具有相关性（P<0.05）；而手术因素即支架扩张最高压力则失去了预测效能。与大出血具有相关性的指标是肌酐（Cr）、低密度脂蛋白胆固醇（LDL-C）、分叉病变、LVEF值（P<0.05）。结论： TC、cTnI、非弥漫性病变成为MACCE的相关因素。与手术因素相比TC、cTnI 、非弥漫性病变对预测MACCE价值更大。而Cr、LDL-C、分叉病变、LVEF值成为大出血的相关因素。

       

      Abstract: AIM:To analyze the relative factors for major adverse cardiac and cerebrovascular events (MACCE) or hemorrhage in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) in hospitals. METHODS: We retrospectively analyzed 280 patients with AMI from September 2006 to August 2010 in the Department of Cardiology, Xijing Hospital, Fourth Military Medical University. Patients were divided into MACCE or hemorrhage group and non-MACCE or non-hemorrhage group. The relationship between factors and MACCE or hemorrhage was analyzed by multivariate logistic regression analysis. RESULTS: TC, cTnI and undiffused coronary artery lesion were correlative factors for MACCE (P<0.05). LDL-C, Crea, bifurcation lesion and LVEF were correlative factors for hemorrhage (P<0.05). CONCLUSION: Compared with PCI, it was demonstrated that TC, cTnI and undiffused coronary artery lesion are more significantly associated with MCCE. LDL-C, Crea, bifurcation lesion and LVEF are significantly associated with hemorrhage.

       

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