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目的:探讨SI与MSI对急性ST段抬高型心肌梗死(STEMI)7 d预后的预测价值。方法:选择2013年1月至2016年1月就诊于承德医学院附属医院急诊科的急性ST段抬高型心肌梗死患者856例,通过测量血压、心率分别计算休克指数(SI)、修正休克指数(MSI)值,据SI、MSI值将其分为4组,SI≥0.7组与SI<0.7组,MSI≥1.4组与MSI<1.4组,对各组间一般资料及主要心脏不良事件(MACE)进行比较。结果:258例患者被纳入MSI升高组(MSI≥1.4),319例患者被纳入SI升高组(SI≥0.7),一般资料比较除了心率、血压之外各组间均差异无统计学意义。本研究中7 d全因病死率为8.4%,MACE发生率为18.2%,SI升高组与MSI升高组均预示较高的MACE发生率,而MSI升高组与SI升高组优势比(ORs)比较均高于SI组,分别为全因病死率13.3~5.0,MACE 3.9~2.5,心源性休克61.3~10.5,致命性心律失常(LTA)5.4~2.7。结论:SI与MSI在急诊对于急性ST段抬高型心肌梗死短期预后均是简单、有效的预测指标,而MSI更准确。
Objective: To investigate the predictive value of SI and MSI for the prognosis of acute ST-segment elevation myocardial infarction (STEMI) on the 7th day. Methods: From January 2013 to January 2016, 856 patients with acute ST-segment elevation myocardial infarction admitted to the emergency department of Chengde Medical College Hospital were enrolled. The shock index (SI) was calculated by measuring the blood pressure and heart rate. The shock index (MSI) were divided into four groups according to SI and MSI values. SI≥0.7 group and SI <0.7 group, MSI≥1.4 group and MSI <1.4 group. The general data and major adverse cardiac events (MACE )Compare. Results: 258 patients were enrolled in MSI elevation group (MSI≥1.4), 319 patients were included in SI elevation group (SI≥0.7). There was no significant difference in general data between groups except heart rate and blood pressure . In this study, the 7-year all-cause mortality rate was 8.4% and the MACE incidence rate was 18.2%. Both SI and MSI increased the incidence of MACE. However, the MSI increased and the SI increased (ORs) were all higher than those in SI group, the all-cause mortality was 13.3-5.0, MACE 3.9-2.5, cardiogenic shock 61.3-10.5, and lethal arrhythmia 5.4-27.7. Conclusion: Both SI and MSI are simple and effective predictors for short-term prognosis of acute ST-segment elevation myocardial infarction in emergency and MSI is more accurate.