摘要
目的系统评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后住院期间发生心力衰竭(HF)的影响因素。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science、Embase公开发表的AMI患者PCI后住院期间发生HF影响因素的病例对照研究(对照组为PCI后住院期间未发生HF的AMI患者,病例组为PCI后住院期间发生HF的AMI患者)。检索时限从建库至2022-06-04。提取纳入文献的资料,采用纽卡斯尔-渥太华量表(NOS)进行文献质量评价,采用RevMan 5.3和Stata15.1软件进行Meta分析。结果本研究纳入27篇文献,共201082例患者,其中病例组9776例、对照组191306例,AMI患者PCI后住院期间HF发生率为3.8%~54.5%。Meta分析结果显示,年龄增加、女性、高血压病史、糖尿病病史、心律失常病史、血糖升高、超敏C反应蛋白(hs-CRP)升高、白细胞计数增多、中性粒细胞计数增多、肌酸激酶同工酶(CK-MB)升高、心肌肌钙蛋白I(cTnI)升高、肌钙蛋白I(TnI)升高、心率增快、发病至PCI时间延长、病变血管数量增多是AMI患者PCI后住院期间发生HF的危险因素,术后TIMI血流分级升高、梗死前心绞痛是AMI患者PCI后住院期间发生HF的保护因素(P<0.05)。结论年龄增加、女性、高血压病史、糖尿病病史、心律失常病史、血糖升高、hs-CRP升高、白细胞计数增多、中性粒细胞计数增多、CK-MB升高、cTnI升高、TnI升高、心率增快、发病至PCI时间延长、病变血管数量增多是AMI患者PCI后住院期间发生HF的危险因素,术后TIMI血流分级升高、梗死前心绞痛是AMI患者PCI后住院期间发生HF的保护因素。AMI患者PCI后住院期间发生HF受多种因素的影响,需要医护人员从多方面采取措施以降低AMI患者HF发生率,改善患者预后。
Objective To systematically evaluate the influencing factors of heart failure(HF)during hospitalization after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Databases including CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of Science,Embase,were retrieved to search for case-control studies on the influencing factors of HF during hospitalization after PCI in patients with AMI from inception to 4 June,2022(the control group included AMI patients without HF during hospitalization after PCI,and the case group included AMI patients with HF during hospitalization after PCI).The data of the included literature were extracted,the Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included literature,RevMan 5.3 and Stata 15.1 were used for meta-analysis.Results A total of 27 articles were included,involving 201082 patients,including 9776 cases in case group and 191306 cases in control group.The incidence rate of HF during hospitalization after PCI in patients with AMI was 3.8%-54.5%.Meta-analysis results showed that increased age,female,history of hypertension,history of diabetes,history of arrhythmia,elevated blood glucose and hypersensitive C-reactive protein(hs-CRP),increased white blood cell count,increased neutrophil count,elevated creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and troponin I(TnI),increased heart rate,prolonged duration from onset to PCI,and increased numbers of disease-vessels were risk factors of HF during hospitalization after PCI in patients with AMI,while elevated postoperative TIMI flow grades and pre-infarction angina pectoris were protective factors of HF during hospitalization after PCI in patients with AMI(P<0.05).Conclusion Increased a age,female,history of hypertension,history of diabetes,history of arrhythmia,elevated blood glucose and hs-CRP,increased white blood cell count,increased neutrophil count,elevated CK-MB,cTnI and TnI,increased heart rate,prolonged duration from onset to PCI,and increased numbers of disease-vessels are risk factors of HF during hospitalization after PCI in patients with AMI,elevated postoperative TIMI flow grades and pre-infarction angina pectoris are protective factors of HF during hospitalization after PCI in patients with AMI.The occurrence of HF during hospitalization after PCI in patients with AMI is affected by many factors,which requires medical staff to evaluate such patients from various aspects,and reduce the incidence of HF and improve the prognosis of patients.
作者
屈俊超
薛孟欣
孙慧平
周静欣
纪思齐
卜媛
胡怡成
刘永兵
QU Junchao;XUE Mengxin;SUN Huiping;ZHOU Jingxin;JI Siqi;BU Yuan;HU Yicheng;LIU Yongbing(School of Nursing·School of Public Health,Yangzhou University,Yangzhou 225009,China)
出处
《实用心脑肺血管病杂志》
2023年第1期77-84,共8页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
江苏省老年教育学习资源库子库项目(苏教继函[2019]2号)
江苏省研究生科研创新计划项目(KYCX21_3298)。
作者简介
通信作者:刘永兵,E-mail:bingbing19950806@163.com。
