胡昊,吴佳纬,李丹,施超,李龙伟,孔祥勇,周俊岭,陈鸿武,马礼坤

• 1:中国科学技术大学附属第一医院(安徽省立医院)心血管内科

摘要(Abstract)：

目的 探讨合并心原性休克（CS）的急性心肌梗死（AMI）患者行急诊经皮冠状动脉介入治疗（PCI）后1年内死亡的预测因素。方法 连续纳入中国科学技术大学附属第一医院2014年1月至2018年1月符合入选条件的所有患者298例。根据1年随访时患者生存情况分为死亡组111例（37.2%）和存活组187例（62.8%）。分析两组患者临床资料，绘制随访1年生存曲线。采用多因素Cox回归分析PCI术后影响远期预后的危险因素。结果 通过多因素Cox回归分析发现有意义的死亡预测因素有4个，分别是年龄≥75岁（HR 1.68,95%CI 1.31～2.16,P<0.001）,PCI术后靶血管心肌梗死溶栓治疗试验（TIMI）血流分级≤Ⅱ级（HR 3.57,95%CI 2.06～6.18,P<0.001）、左心室射血分数<40%(HR 0.45,95%CI 0.26～0.78,P=0.004)以及首次医疗接触至球囊扩张（FMC-to-B）时间>12h(HR 7.52,95%CI 3.28～17.24,P<0.001)。1年随访Kaplan-Meier生存曲线显示AMI合并CS患者行急诊PCI术后3个月内死亡率高。结论 主动脉内球囊反搏是AMI合并CS最常用的机械循环辅助救治手段。在众多危险因素中FMC-to-B时间延迟、PCI术后靶血管TIMI血流分级≤Ⅱ级、高龄、左心室射血分数低是AMI合并CS患者PCI术后1年内死亡的预测因素。

关键词(KeyWords)： 主动脉内球囊反搏;急性心肌梗死;心原性休克;支架置入

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（81870192）;; 安徽省卫生健康委科研项目（AHWJ2021b080）

作者(Author): 胡昊,吴佳纬,李丹,施超,李龙伟,孔祥勇,周俊岭,陈鸿武,马礼坤

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