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目的 确定接受急诊经皮冠状动脉干预 (PCI)的急性心肌梗死 (AMI)患者死亡的风险因素。方法 对1997年 1月至 1999年 4月行直接经皮腔内冠状动脉成形术 (PTCA)的急性心肌梗死患者 2 16例中死亡的 14例病例 ,采用Logistic多元回归分析并分析其死亡原因。结果 住院期间死亡率为 5 5 % ,死亡原因分别为心源性休克 7人(3 2 % ) ,急性左心衰竭 2人 (0 9% ) ,室颤 1人 (0 4% ) ,心肌梗死后 2周上消化道出血致死 1人 (0 4% ) ,冠状动脉旁路移植术 (CABG)后大出血死亡 1人 (0 4% )。随访期间死亡 2人 (0 9% ) ,死亡原因分别为 2 5月后再次心源性休克和 1年后突然室颤。结论 影响接受直接PTCA术的急性心肌死患者的死亡有意义的独立危险因素依次排列如下 :梗死相关血管 (IRA)术后TIMI血流 (0 -1级 )、严重心律失常、IRA (左主干、右冠状动脉和前降支 )和出院前再缺血事件
Objective To determine the risk factors for death in patients undergoing acute percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI). Methods A total of 14 patients died of acute myocardial infarction (PTCA) from January 1997 to April 1999 were analyzed retrospectively. Logistic regression analysis was used to analyze the causes of death. Results The mortality rate during hospitalization was 55%. The causes of death were 7 cases of cardiogenic shock (32%), 2 cases of acute left heart failure (0 9%), 1 person of ventricular fibrillation (0 4%), myocardial infarction 1 died of upper gastrointestinal bleeding in 2 weeks (04%), and 1 died of massive bleeding after coronary artery bypass grafting (CABG) (0 4%). Two people died during follow-up (0 9%). The causes of death were cardiogenic shock after 25 months and sudden ventricular fibrillation after one year. CONCLUSION: The independent risk factors influencing death in patients with acute myocardial infarction undergoing direct PTCA were ranked as follows: TIMI flow (grade 0-1), severe arrhythmia, IRA (left main trunk, Right coronary artery and anterior descending artery) and pre-discharge ischemic events