急性心肌梗死并发室间隔穿孔患者院内死亡的相关因素分析

肖文涛; 张静; 高传玉; 郭素萍; 刘煜昊; 赵子牛; 齐大屯; 叶发民; 张优

doi:10.13201/j.issn.1001-1439.2021.12.003

急性心肌梗死并发室间隔穿孔患者院内死亡的相关因素分析

- 1. 阜外华中心血管病医院河南省人民医院心脏中心心脏重症医学科冠心病重症监护室(郑州, 451464);
- 2. 阜外华中心血管病医院冠心病病区;
- 3. 阜外华中心血管病医院结构性心脏病病区;
- 4. 阜外华中心血管病医院心脏外科;
- 5. 河南省心血管流行病学研究中心
基金项目:
河南省医学科技攻关计划项目(No:201602210)

详细信息

通讯作者: 郭素萍,E-mail:gsp389@126.com

中图分类号: R542.2

收稿日期: 2021-07-14

修回日期: 2021-08-07

Related factors of in-hospital death in patients with post-infarction ventricular septal rupture

- 1. Department of Cardiac Intensive Medicine, Fuwai Central China Cardiovascular Hospital He'nan Provincial People's Hospital;
- 2. Coronary Heart Disease Ward, Fuwai Central China Cardiovascular Hospital He'nan Provincial People's Hospital;
- 3. Structural Heart Disease Ward, Fuwai Central China Cardiovascular Hospital He'nan Provincial People's Hospital;
- 4. Cardiac Surgery Ward, Fuwai Central China Cardiovascular Hospital He'nan Provincial People's Hospital, Zhengzhou, 451464, China;
- 5. He'nan Institute of Cardiovascular Epidemiology

More Information

Corresponding author: GUO Suping, E-mail: gsp389@126.com

Received Date: 14 July 2021

Revised Date: 07 August 2021

摘要

摘要: 目的:分析急性心肌梗死(AMI)并发室间隔穿孔(VSR)患者院内死亡的相关因素。方法:回顾性分析我院冠心病监护病房(CCU)2018年1月—2020年12月收治的92例AMI并VSR患者的临床资料,根据是否发生院内死亡,将患者分为院内死亡组(45例)和院内存活组(47例),分析患者院内死亡的相关因素。结果:AMI并发VSR患者院内病死率为48.9%。院内存活组与院内死亡组患者入住CCU时Killip心功能Ⅲ~Ⅳ级、B型利钠肽(BNP)水平、平均动脉压(MAP)、血乳酸、白细胞、C反应蛋白(CRP)、序贯器官衰竭评分(SOFA评分)、住院期间合并消化道出血患者比例、手术治疗患者比例及住院时长均差异有统计学意义(均P<0.05)。Logistic多因素回归分析显示,患者入住CCU时SOFA评分(OR=1.501,95%CI:1.211~1.862,P<0.01)及住院期间手术治疗(OR=0.035,95%C1:0.007~0.168,P<0.01)是患者院内死亡的独立相关因素。结论:手术(介入封堵术及外科修补术)是治疗AMI并发VSR患者的有效手段,而患者入住CCU第1天的SOFA评分可能与患者院内死亡相关。
- 心肌梗死 /
- 室间隔穿孔 /
- 病死率
Abstract: Objective: To analyze the related factors of in-hospital death in patients with acute myocardial infarction(AMI) complicated with ventricular septal perforation(VSR).Methods: A total of 92 consecutive patients with AMI and VSR admitted to the Coronary Care Unit(CCU) of our hospital from January 2018 to December 2020 were enrolled and analyzed retrospectively. Patients were divided into the in-hospital death group(n=45), and the in-hospital survival group(n=47), and the related factors of in-hospital death were analyzed.Results: The in-hospital mortality of AMI patients with VSR was 48.9%. There were significant differences in Killip grade Ⅲ to Ⅳ, B-type natriuretic peptide(BNP) level, mean arterial pressure(MAP), blood lactic acid, white blood cells, C-reactive protein(CRP), sequential organ failure score(SOFA score), the proportion of gastrointestinal bleeding and surgical treatment during hospitalization, and length of hospitalization between the in-hospital death group and the in-hospital survival group(all P<0.05). Logistic regression analysis showed that SOFA score at the admission of CCU(OR=1.501, 95%CI: 1.211-1.862, P<0.01) and surgical treatment during hospitalization(OR=0.035, 95%CI: 0.007-0.168, P<0.01) were independent related factors of in-hospital death.Conclusion: Surgery(percutaneous closure and surgical repair) is an effective therapy to treat AMI patients with VSR. The SOFA score on the first day of admission to CCU may be related to the patient's in-hospital death.
- myocardial infarction /
- ventricular septal rupture /
- mortality

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