论文部分内容阅读
目的研究心肌梗死溶栓疗法(TIMI)危险评分、血清心肌标志物及其他临床因素对急性心肌梗塞(AMI)患者急性期主要心脏不良事件(MACE)发生及预测的影响。方法随机选取2013年6月至2016年6月本院收治的急性心肌梗塞患者300例,根据患者在发病1个月内是否发生过主要心脏不良事件将患者分为发生组和不发生组,分析患者的TIMI危险评分、血清心肌标志物及其他临床因素对MACE发生与否的影响,进一步将发生过MACE的患者预后分为生存组和死亡组,分析影响患者死亡的因素。结果在300例患者中,MACE发生组196例,不发生组104例,其中纳入生存组的患者有150例,纳入死亡组的有46例,单因素分析结果为:年龄、TIMI危险评分、氨基末端脑钠肽前体(NT-proBNP)值、高血压在MACE发生组与不发生组间比较,差异均有统计学意义(P<0.05);进一步分析影响患者的死亡因素,年龄、TIMI危险评分、血清NT-proBNP、高血压为MACE患者发生死亡的危险因素,差异有统计学意义(P<0.05)。血清NT-proBNP值大于4 200 pg/m L及TIMI危险评分>9分患者死亡风险较高。结论 TIMI评分和血清心肌标记物等临床因素对临床治疗具有指导作用,患者的TIMI危险评分越高、血清NT-proBNP值越大,其发生MACE的可能性越大。
Objective To investigate the impact of myocardial infarction thrombolytic therapy (TIMI) risk score, serum myocardial markers and other clinical factors on the occurrence and prediction of acute cardiac event (MACE) in patients with acute myocardial infarction (AMI). Methods 300 cases of acute myocardial infarction admitted to our hospital from June 2013 to June 2016 were randomly selected and divided into the occurrence group and the non-occurrence group according to whether the patients had major adverse cardiac events within 1 month of onset. TIMI risk score of patients, serum myocardial markers and other clinical factors on the occurrence of MACE or not, and further divided the prognosis of patients with MACE into survival group and death group, analysis of the factors that affect the patient’s death. Results Of the 300 patients, MACE occurred in 196 patients, 104 patients did not occur. Among them, 150 patients were included in the survival group and 46 patients were included in the death group. The univariate analysis showed that age, TIMI risk score, amino group The NT-proBNP value and hypertension were significantly different between MACE group and non-MACE group (P <0.05). The risk factors of death, age, TIMI risk were further analyzed Score, serum NT-proBNP and hypertension were the risk factors of death in MACE patients, the difference was statistically significant (P <0.05). Patients with a serum NT-proBNP greater than 4 200 pg / m L and a TIMI risk score> 9 had a higher risk of death. Conclusion Clinical factors such as TIMI score and serum myocardial markers play a guiding role in clinical treatment. The higher the TIMI risk score and the greater the serum NT-proBNP value, the greater the possibility of MACE.