摘要
背景与同龄男性相比,更年期女性急性ST段抬高型心肌梗死(ASTEMI)患者经皮冠状动脉介入治疗(PCI)后预后较差,而血细胞比容(Hct)对更年期女性ASTEMI患者PCI后预后的影响尚不清楚。目的探讨Hct对更年期女性ASTEMI患者PCI后心功能、生活质量及不良事件的影响。方法选取2015年2月-2018年1月在哈励逊国际和平医院行PCI的更年期女性ASTEMI患者184例,根据Hct分为<0.33组58例、0.33~0.39组62例、>0.39组64例。比较三组患者PCI后7 d、1个月、6个月、12个月心率(HR)、收缩压(SBP)、舒张压(DBP)、心功能指标〔包括氨基末端脑钠肽前体(NT-proBNP)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、心输出量(CO)及心脏指数(CI)〕、健康状况调查简表(SF-36)评分及随访12个月不良事件发生率。结果(1)三组患者PCI后7 d、1个月、6个月、12个月HR、SBP、DBP比较,差异无统计学意义(P>0.05)。(2)三组患者PCI后7 d NT-proBNP、LVEDV、LVESV、LVEF、CO、CI及PCI后1个月CO比较,差异无统计学意义(P>0.05)。PCI后1、6、12个月,<0.33组患者NT-proBNP高于0.33~0.39组、>0.39组,LVEDV、LVESV小于0.33~0.39组、>0.39组,LVEF低于0.33~0.39组、>0.39组,CO小于>0.39组,CI低于>0.39组(P<0.05);而0.33~0.39组患者NT-proBNP高于>0.39组,LVEDV、LVESV小于>0.39组,LVEF低于>0.39组(P<0.05)。PCI后12个月,<0.33组患者CO小于0.33~0.39组(P<0.05)。PCI后6、12个月,0.33~0.39组患者CO小于>0.39组,<0.33组和0.33~0.39组患者CI低于>0.39组(P<0.05)。(3)三组患者PCI后7 d SF-36评分比较,差异无统计学意义(P>0.05)。PCI后1、6、12个月,<0.33组SF-36评分低于0.33~0.39组、>0.39组,0.33~0.39组患者SF-36评分低于>0.39组(P<0.05)。(4)随访12个月<0.33组患者不良事件发生率高于>0.39组(P<0.05)。结论 Hct越低,更年期女性ASTEMI患者PCI后心功能及生活质量越差,不良事件发生风险越高,应注意检测Hct以改善患者预后。
Background Prognosis in postoperative menopausal ASTEMI women treated by PCI is relatively poor compared with that in men with same age,whereas impact of hematocrit on the prognosis in postoperative menopausal ASTEMI women treated by PCI is not clear so far.Objective To investigate the impact of hematocrit on cardiac function,quality of life and adverse events in postoperative menopausal ASTEMI women treated by PCI.Methods A total of 184 menopausal ASTEMI women undergoing PCI were selected in Harrison International Peace Hospital from February 2015 to January 2018,and they were divided into A group(with hematocrit <0.33,n=58),B group(with hematocrit from 0.33 to 0.39,n=62)and C group(with hematocrit >0.39,n=64).HR,SBP,DBP,index of cardiac function(including NT-proBNP,LVEDV,LVESV,LVEF,CO and CI)and SF-36 score 7 days,1 month,6 months and 12 months after PCI,incidence of adverse events during the 12-month follow-up were compared in the three groups.Results(1)There was no statistically significant difference in HR,SBP or DBP in the three groups 7 days,1 month,6 months and 12 months after PCI(P>0.05).(2)There was no statistically significant difference in NT-proBNP,LVEDV,LVESV,LVEF,CO or CI 7 days after PCI and CO 1 month after treatment in the three groups(P>0.05).1,6 and 12 months after PCI,NT-proBNP in A group was statistically significantly higher than that in B group and C group,LVEDV,LVESV and LVEF in A group were statistically significantly less than those in B group and C group,CO in A group was statistically significantly less than that in C group,CI in A group was statistically significantly lower than that in C group(P<0.05);while NT-proBNP in B group was statistically significantly than that in C group,LVEDV,LVESV and LVEF in B group was statistically significantly less than that in C group(P<0.05).12 months after PCI,CO in A group was statistically significantly less than that in B group(P<0.05).6 and 12 months after PCI,CO in B group was statistically significantly less than that in C group,CI in A group and B group was statistically significantly lower than that in C group(P<0.05).(3)No statistically significant difference of SF-36 score was found in the three groups 7 days after PCI(P>0.05);1 month,6 months and 12 months after PCI,SF-36 score in A group was statistically significantly lower than that in B group and C group,respectively,meanwhile SF-36 score in B group was statistically significantly lower than that in C group(P<0.05).(4)Incidence of adverse events in A group was statistically significantly higher than that in B group and C group during the 12-month follow-up,respectively,meanwhile incidence of adverse events in B group was statistically significantly higher than that in C group(P<0.05).Conclusion As hematocrit reduces,cardiac function and quality of life go from bad to worse while risk of adverse events increases in postoperative menopausal ASTEMI women treated by PCI,so we should pay attention to the detection hematocrit to improve the prognosis.
作者
李凤德
武晓玲
杨红红
赵玲
扈晓霞
郑群
LI Fengde;WU Xiaoling;YANG Honghong;ZHAO Ling;HU Xiaoxia;ZHENG Qun(Harrison International Peace Hospital,Hengshui 053000,China)
出处
《实用心脑肺血管病杂志》
2019年第7期18-22,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
河北省科技计划项目(20160315)
衡水市科技计划项目(2017014013C-15)
关键词
心肌梗死
血细胞比容
更年期
女性
经皮冠状动脉介入治疗
心功能
生活质量
Myocardial infarction
Hematocrit
Climacteric
Femininity
Percutaneous coronary intervention
Cardiac function
Quality of life
作者简介
通信作者:李凤德,E-mail:lifengde3310@163.com.
