刘宇,丰德京,王乐丰,李奎宝,王洪江,杨新春,王红石,徐立,夏昆,倪祝华,李惟铭,张大鹏,何冀芳,孙昊,郭宗生,张智勇,姜锋,钟久昌,卢燕,张英

• 1:首都医科大学附属北京朝阳医院心脏中心北京高血压重点实验室
• 2:河北省廊坊长征医院心内科
• 3:山东省菏泽市牡丹人民医院心内科

摘要(Abstract)：

目的探讨影响急性心肌梗死(AMI)合并心原性休克(CS)患者住院期间死亡的因素。方法回顾性分析2002年4月至2019年4月于首都医科大学附属北京朝阳医院心脏中心接受治疗的321例AMI合并CS患者的临床资料。将患者分为院内死亡组(230例)和院内生存组(91例)。比较两组患者的基线特征、冠状动脉造影和介入治疗特征、心功能和生化指标。结果与院内生存组相比,院内死亡组患者年龄偏大,院前时间偏长,非ST段抬高型心肌梗死比例偏高;三支冠状动脉病变发生率高,实施心肺复苏比例高,急诊经皮冠状动脉介入治疗(PCI)率偏低;血清肌酐和B型脑钠肽显著增高。两组主动脉内球囊反搏(IABP)置入率相当(82.3%比86.8%,P=0.349)。两组左心室射血分数、肌钙蛋白I峰值、低密度脂蛋白胆固醇、白细胞计数、红细胞沉降率和C反应蛋白比较,差异均无统计学意义(均P>0.05)。logistic多因素回归分析显示,年龄(OR 1.005,95%CI 0.992～1.212,P=0.047)、院前时间(OR 0.898,95%CI 0.991～1.006,P=0.048)、急诊PCI(OR 0.331,95%CI 0.103～3.521,P=0.039)和实施心肺复苏(OR 7.238,95%CI 1.620～32.343,P=0.010)是AMI合并CS住院期间死亡的独立预测因素。结论 IABP置入不影响AMI合并CS住院期间生存率。年龄、院前时间、急诊PCI和实施心肺复苏是住院期间死亡的独立预测因素。

关键词(KeyWords)： 急性心肌梗死;心原性休克;主动脉内球囊反搏

Abstract:

Keywords:

基金项目(Foundation): 北京市医院管理中心消化内科学科协同发展中心消化专项重点项目子课题(XXZ0607)

作者(Author): 刘宇,丰德京,王乐丰,李奎宝,王洪江,杨新春,王红石,徐立,夏昆,倪祝华,李惟铭,张大鹏,何冀芳,孙昊,郭宗生,张智勇,姜锋,钟久昌,卢燕,张英

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