急性心肌梗死患者PCI术后并发急性脑梗死的发生率及其危险因素

云霞; 武力勇; 吴明正; 姚黎清

doi:10.13191/j.chj.2015.0055

急性心肌梗死患者PCI术后并发急性脑梗死的发生率及其危险因素

Incidence and risk factors of acute cerebral infarction complicated by acute myocardial infarction after percutaneous coronary intervention

摘要

摘要: 目的:探讨急性心肌梗死(acute myocardial infarction,AMI)经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)患者术后并发急性脑梗死的发生率及其危险因素。方法:回顾性分析我科于2008年1月²014年1月收治的635例AMI行PCI术的患者,搜集到20例术后出现脑梗死的患者,未发生脑梗死的患者615例作为对照组,分析两组临床资料。结果:AMI患者进行PCI术后发生脑梗死20例,其发生率为3.1%。Logistic回归分析表明:术后并发脑梗死的危险因素,年龄、术后低血压、广泛前壁心梗、房颤、球囊扩张次数(P<0.05,OR>1)为术后并发脑梗死的独立危险因素。抗凝血酶(AT-Ⅲ)的降低是并发脑梗死的危险因素(P<0.05,OR<1)。结论:AMI行PCI后并发脑梗死的发生率为3.1%,年龄、术后低血压、广泛前壁心梗、房颤、球囊扩张次数为AMI行PCI术后并发脑梗死的独立危险因素,抗凝血酶为保护因素。

Abstract: AIM: To investigate the incidence and the risk factors of acute cerebral infarction complicated by acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI). METHODS: A retrospective analysis was carried out in 635 patients with AMI undergoing PCI in our department from January 2008 to January 2014. Clinical data of the 20 cases with postoperative cerebral infarction and the 615 cases with no postoperative cerebral infarction were analyzed. RESULTS: The incidence of postoperative cerebral infarction after PCI in acute myocardial infarction patients was 3. 1%. Logistic regression analysis showed that the independent risk factors for postoperative cerebral infarction were age,postoperative hypotension,extensive anterior wall myocardial infarction,atrial fibrillation,and balloon times( P < 0. 05,OR> 1). Reduction of antithrombin( AT-Ⅲ) was a risk factor for cerebral infarction( P < 0. 05,OR < 1).CONCLUSION: The incidence of postoperative cerebral infarction after PCI in AMI patients is 3. 1%.The independent risk factors of postoperative cerebral infarction are age,postoperative hypotension,extensive anterior wall myocardial infarction,atrial fibrillation and balloon times. AT-Ⅲ is a protective factor.

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