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目的探讨影响急性心肌梗死(AMI)患者行经皮冠状动脉介入术(PCI)后住院期间死亡的危险因素。方法回顾性分析2009年1月至2011年9月因AMI入住我院并行PCI的275例患者的一般情况、既往史、入院情况、术中及术后情况、并发症等资料,对可能影响术后死亡的危险因素通过logistic回归模型进行分析。结果多因素logistic回归分析表明,女性(P=0.047,OR=2.91)、广泛前壁心肌梗死(P=0.044,OR=3.07)、肾功能不全史(P=0.021,OR=7.98)、发生心源性休克(P=0.008,OR=15.71)、术后心肌梗死溶栓(TIMI)血流<3级(P=0.016,OR=5.61)、置入主动脉内球囊反搏(IABP;P=0.043,OR=3.49)。结论影响AMI患者行PCI术后院内死亡的危险因素为女性、广泛前壁心肌梗死、置入IABP、术后TIMI血流<3级、肾功能不全史和发生心源性休克。
Objective To investigate the risk factors of hospital mortality during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A retrospective analysis of the general situation, past history, admission, intraoperative and postoperative complications, complications and other data of 275 patients admitted to our hospital from January 2009 to September 2011 with AMI were retrospectively analyzed. Post-mortem risk factors were analyzed by logistic regression model. Results Multivariate logistic regression analysis showed that there were significant differences in the incidence of extensive anterior myocardial infarction (P = 0.044, OR = 3.07), renal insufficiency (P = 0.021, OR = 7.98) (P = 0.008, OR = 15.71), myocardial infarction thrombolysis (TIMI) blood flow <3 (P = 0.016, OR = 5.61) and aortic balloon pump = 0.043, OR = 3.49). Conclusions The risk factors for in-hospital mortality after PCI in AMI patients are women, extensive anterior myocardial infarction, IABP insertion, postoperative TIMI flow grade 3, history of renal insufficiency, and cardiogenic shock.