论文部分内容阅读
目的探讨急性ST段抬高型心肌梗死(STEMI)患者靶血管术前闭塞程度与院内死亡发生率的关系。方法本研究为回顾性分析,从全军心血管介入治疗管理系统中选取接受冠脉介入治疗的8170例STEMI患者,研究终点为院内死亡发生率。对患者靶血管术前闭塞程度进行分层,探讨靶血管闭塞程度对院内死亡发生率的影响。结果根据靶血管术前闭塞程度,将8170例患者分为两组:75%~99%狭窄(n=2191)和100%狭窄(n=5979)。两组患者的院内死亡发生率分别为2.2%和3.0%(P=0.077)。进一步根据症状出现至血管开通时间对患者进行分层,症状出现至血管开通时间<3h时,上述两组患者的院内死亡发生率分别为2.5%和3.3%(P=0.436);症状出现至血管开通时间为3~6h时,上述两组患者的院内死亡发生率分别为2.0%和2.9%(P=0.147);症状至血管开通时间>6h时,上述两组患者的院内死亡发生率分别为2.4%和2.8%(P=0.430),差异无统计学意义。结论 STEMI患者院内死亡发生率与靶血管术前闭塞程度可能无关。
Objective To investigate the relationship between preoperative target vessel occlusion and the incidence of in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods In this retrospective analysis, 8170 STEMI patients undergoing PCI were enrolled in the PLA cardiovascular management system. The study endpoint was hospital mortality. The degree of preoperative occlusion of target vessel was stratified to investigate the effect of target vessel occlusion on the incidence of nosocomial death. Results According to the degree of preoperative occlusion of target vessels, 8170 patients were divided into two groups: 75% -99% stenosis (n = 2191) and 100% stenosis (n = 5979). In-hospital mortality rates were 2.2% and 3.0% for both groups (P = 0.077). Patients were further stratified by the onset of symptoms to the time of opening of the vessel. The incidence of nocturnal mortality in these two groups was 2.5% and 3.3%, respectively (P = 0.436), when symptoms were present to the time when the blood vessel was opened The incidence of nosocomial death in the above two groups was 2.0% and 2.9%, respectively (P = 0.147) when the opening time was 3 ~ 6h. The incidence of nosocomial death in the above two groups was 2.4% and 2.8% (P = 0.430), the difference was not statistically significant. Conclusion The incidence of nosocomial death in STEMI patients may not be related to the preoperative occlusion degree of target vessel.