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[1]何 军,杨燕妮,申立波.主动脉内球囊反搏泵置入患者住院死亡危险因素分析[J].宁夏医科大学学报,2019,(12):1222-1226.[doi:10.16050/j.cnki.issn1674-6309.2019.12.007]
 HE Jun,YANG Yanni,SHEN Libo.Analysis of the Death Risk Factors in Patients with Intro-aortic Balloon Pump Treatment[J].Ningxia Medical University,2019,(12):1222-1226.[doi:10.16050/j.cnki.issn1674-6309.2019.12.007]
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主动脉内球囊反搏泵置入患者住院死亡危险因素分析(PDF)
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《宁夏医科大学学报》[ISSN:1005-8486/CN:64-1029/R]

卷:
期数:
2019年12期
页码:
1222-1226
栏目:
论著
出版日期:
2020-03-27

文章信息/Info

Title:
Analysis of the Death Risk Factors in Patients with Intro-aortic Balloon Pump Treatment
文章编号:
1674-6309(2019)12-1222-05
作者:
何 军1 杨燕妮2 申立波3
(1. 宁夏医科大学总医院心脏中心内科,银川 750004; 2. 银川国龙医院内科,银川 750004; 3. 宁夏银川市第一人民医院心内科,银川 750001)
Author(s):
HE Jun1 YANG Yanni2 SHEN Libo3
(1. Department of Cardiology,the General Hospital of Ningxia Medical University,Yinchuan 750004,China; 2. Department of Internal Medicine,Yinchuan Guolong Hospital,Yinchuan 750004,China; 3. Department of Cardiology, the First People’s Hospital of Yinchuan,Yinchuan 750001,China )
关键词:
主动脉内球囊反搏泵死亡危险因素
Keywords:
intra-aortic balloon counterpulsation pump death risk factor
分类号:
R541
DOI:
10.16050/j.cnki.issn1674-6309.2019.12.007
文献标志码:
A
摘要:
目的 分析主动脉内球囊反搏泵 (intra-aortic balloon pump, IABP)置入患者住院死亡危险因素。方法 通过回顾性分析IABP置入患者的临床特点, 经Logistic分析患者住院死亡的危险因素。结果 共纳入303例患者,平均年龄(63.6±12.5)岁,男女比例3.74∶1,急性心肌梗死患者占78.6%,45.6%合并心源性休克,住院总病死率为33.3%。死亡组年龄大于存活组(P<0.05),男性多于存活组(P<0.05);死亡组肺部感染、高血压病、2型糖尿病、慢性肾功能不全和房颤发生率均高于存活组(P<0.05或<0.01),呼吸机和血管活性药物使用率和穿刺部位血肿发生率均高于存活组(P均<0.01)。IABP置入死亡组后收缩压、舒张压和左心室射血分数(LVEF)的升高幅度低于存活组(P<0.05或<0.01),左心室舒张末内径(LVEDD)增大幅度高于存活组 (P均<0.05)。出院与入院时白细胞计数、血红蛋白含量、血小板数量和血肌酐、尿素氮、白蛋白、D-二聚体、N端脑钠肽前体(NT-proBNP)、肌钙蛋白I (cTnI)、动脉血乳酸水平及动脉血氧饱和度变化幅度两组差异有统计学意义 (P均<0.05)。Logistic分析显示,年龄≥65岁、男性、入院LVEF、入院心功能Killip分级≥III级、PCI术后TIMI血流≤2级、IABP使用时间≥90 h、股动脉穿刺部位血肿及基础血肌酐、乳酸、血糖水平是患者住院死亡的独立危险因素。结论 接受IABP循环支持者以急性心肌梗死并实施了经皮冠状动脉内介入(PCI)治疗的患者为主,其住院死亡风险主要决定于患者基础疾病的危重程度,男性、入院时心功能Killip分级≥III级和股动脉穿刺处血肿形成具有较强的预测死亡的作用。
Abstract:
Objective To analyze the risk factors of death in patients with intra-aortic balloon counterpulsation pump(IABP) implantation. Methods By retrospective analyzing the clinical characteristics of 303 in-hospital patients supported by IABP,to illustrate the risk factors of death by means of Logistic analysis. Results The mean of age was (63.6±12.5). The ratio of male to female was 3.74∶1, and 78.6% out of the patients were acute myocardial infarction(AMI). 45.6% of the subject accompanied by cardiogenic shock(CS). The in-hospital mortality was 33.3%. Hypertension, type 2 diabetes, chronic renal insufficiency, atrial fibrillation, lung infection, respirator & vasoactive medications, and hematoma formation were much common among the non-survivors(P all<0.05 or<0.01). After IABP insertion, the augments of systolic blood pressure, diastolic blood pressure and left ventricular ejection fraction(LVEF) of the non-survivors were lower than that of the survivor group(P<0.01). However, the augment of left ventricular end-diastolic diameter(LVEDD) increased in the non-survivor group(P<0.05). The differences about the final and the baseline of leukocyte, hemoglobin, platelet, glucose, creatinine, urea nitrogen, albumin, D dimer, N-terminal pro-brain natriuretic peptide (NT pro-BNP), cardiac troponin I (cTnI), lactic acid level and arterial oxygen saturation (SpO2) were statistically different between the two groups (P all<0.05). Logistic analysis indicated that age ≥65, male, IABP duration ≥90 hours, femoral hematoma, baselines of blood creatinine, lactic acid and glucose were risk factors of death. Conclusion In the present study, the subject mainly consisted of acute myocardial infarction(AMI) patients accepted percutaneous coronary intervention(PCI)treatment. The death risk mainly depends upon their admission conditions. Male,baseline Killip Class≥III and femoral hematoma showed strong effects on predicting death.

参考文献/References:

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备注/Memo

备注/Memo:
收稿日期:2019-06-27
作者简介:何军(1968-),宁夏人,主任医师,博士,从事心血管内科临床、教学和科研工作。
更新日期/Last Update: 2019-12-30