急性心肌梗死患者行急诊经皮腔内冠状动脉成形术住院期间死亡因素分析Predictive factors of in-hospital death in patients with acute myocardial infarction (AMI) after emergency percutaneous transluminal coronary angioplasty (PTCA)
曲新凯 ,方唯一 ,周旭晨 ,朱皓 ,董福宏
摘要(Abstract):
目的 分析大连医科大学附属一院急性心肌梗死 (AMI)住院期间行急诊经皮腔内冠状动脉成形术 (PTCA)的情况 ,探讨影响住院期间死亡的因素。方法 选择自 1996年 6月至 2 0 0 1年 3月首次AMI接受急诊PTCA治疗的患者 4 3例 ,男性 30例 ,女性 13例 ,年龄 (6 0 5± 12 6 )岁。住院期间死亡 7例 (16 3%)。结果 伴有Killip 3级以上、心源性休克患者死亡率分别为 5 8 3%、4 4 4 %,明显高于没有这些并发症的患者 ;病变血管为完全闭塞病变患者的死亡率 (2 0 6 %)明显高于非完全闭塞病变者 (0 %) ;术中急性血栓形成患者死亡率 (40 0 %)明显高于无血栓形成者 (9 1%)。结论 伴有心源性休克、Killip 3级以上心衰、以及病变血管为完全闭塞病变、术中并发急性血栓形成是急性心肌梗死患者行急诊PTCA住院期间死亡的危险因素。
关键词(KeyWords): 急性心肌梗死;血管成形术,经腔,经皮冠状动脉;死亡;危险因素
基金项目(Foundation):
作者(Author): 曲新凯 ,方唯一 ,周旭晨 ,朱皓 ,董福宏
参考文献(References):
- 1QueirosMC ,PintoPF ,SilvaJC ,etal.Determinationsofin hospitalmortalityinwomenwithacutemyocadiolinfarctionprimarycoronaryangioplasty.RevPortCardiol,2000,19:11571161.
- 2HaaseKK ,SchielcR ,WagnerS ,etal.In hospitalmortalityofelderlypatientswithacutemyocardialinfarction:datafromtheMITRAregistry.ClinCardiol,2000,23:831836.
- 3SilvaJA ,RameeSR ,WhiteCJ ,etal.Primarystentinginacutemyocardialinfarction:influenceofdiabetemellitusinangioplasticresultsandclinicaloutcome.AmHeartJ ,1999,138(3p1):446455.
- 4MoscucciM ,KlineRogerE ,ShareD ,etal.Simplebedsideadditivetoolforpredictionofin hospitalmortalityafterpercutaneouscoronaryinterventions.Circulation,2001,104:263268.
- 5DeGeareVS ,BouraJA ,GrinesLL ,etal.PredictivevalueoftheKillipclassificationinpatientsundergoingprimarypercutaneouscoronaryinterventionforAMI.AmJCardiol,2001,87:1035.
- 6BrenerSJ ,EllisSG ,SappSK ,etal.Predictorsofdeathandre infarctionat30daysafterprimaryangioplasty:theGUSTOIIbandRAPPORTtrials.AmHeartJ,2000,139:476481.
- 7NathewV ,GarrattKN ,HolmesDRJr.Clinicaloutcomeaftermultivesselcoronarystentimplation.AmHeartJ ,1999,138(6pt1):11051110.
- 8BriguoriC ,NishidaT ,AdamianM ,etal.Multivesselcoronarystenting:predictorsofearlyandlateoutcome.ItalHeartJ ,2000,1:420425.
- 9MorenoR ,GarciaE ,SorianoJ,etal.EarlycoronaryangioplastyforAMI:predictorsofpooroutcomeinanon selectedpopulation.JInvasiveCardiol,2001,13:202210.
- 10GoethalsP ,EvrardS ,DuboisC .Recurrentcoronarystentthrombosis.ActaCardiol,2000,55:371373.