de Winter综合征患者临床特征及1年预后Analysis clinical features and prognosis of one-year patients with de Winter syndrome
汤玮,胡荣,赵冬婧,唐学弘,程国杰,马晶
摘要(Abstract):
目的探讨de Winter综合征患者的临床特征、院内及1年预后情况。方法选取首都医科大学大兴教学医院2019年1月至2020年1月确诊为de Winter综合征的患者18例作为观察组,选取同期收治的急性前壁ST段抬高型心肌梗死(STEMI)患者62例作为对照组,比较两组患者的临床特征、院内以及1年主要不良事件发生情况。结果观察组男性(94.4%比69.4%)和吸烟者(72.2%比41.9%)占比均高于对照组,平均年龄[(50.6±9.4)岁比(62.0±12.6)岁]、肌酸激酶峰值[1194.5(589.0,1850.5)U/L比1991.5(1399.5,3726.0)U/L]以及B型脑钠肽[111.0(53.0,238.7)pg/ml比218.0(147.7,315.0)pg/ml]均低于对照组,而左心室射血分数高于对照组[(56.0±7.2)%比(50.1±6.7)%],差异均有统计学意义(均P<0.05)。急诊冠状动脉造影提示观察组单支病变占比高于对照组(50.0%比24.2%),而术中及术后血管活性药物的使用率低于对照组(16.7%比46.8%),差异均有统计学意义(均P<0.05)。观察组入门至球囊扩张(D-to-B)时间长于对照组[(89.2±14.14)min比(74.0±18.12)min],而住院时间短于对照组[(8.8±2.4)d比(11.2±3.2)d],差异均有统计学意义(均P<0.05)。观察组住院期间心力衰竭发生率(16.7%比46.8%)以及1年再住院率(13.3%比49.1%)均明显低于对照组,差异均有统计学意义(均P<0.05)。结论 de Winter综合征患者男性吸烟者多见,发病年龄小,院内心力衰竭发生率及1年再住院率低,但D-to-B时间长于STEMI患者,需要进一步加强重视。
关键词(KeyWords): 心肌梗死;de Winter综合征;临床特征;预后
基金项目(Foundation): 北京市科技计划课题项目(Z171100001017243)
作者(Author): 汤玮,胡荣,赵冬婧,唐学弘,程国杰,马晶
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