| Objective:To explore the clinical characteristics and risk factors for death within 28days in patients with ST-segment elevation myocardial infarction assisted by traumatic mechanical ventilation.Methods:The clinical data of 368 patients with ST-segment elevation myocardial infarction treated by emergency PCI were selected,in the Affiliated Hospital of Zunyi Medical University,from October 2020 to September 2021.The patients were divided into mechanical ventilation group and non-mechanica ventilation group,According to whether the patients undergone mechanical ventilation auxiliary treatment,71 cases of mechanical ventilation group,297cases of non-mechanical ventilation group.71patients with mechanical ventilation were divided into 48 patients in the death group and 23 patients in the survival group according to whether they died or not.To compare the clinical basic data,laboratory examination,auxiliary treatment methods and mortality within 28 days of the two groups of patients,and analysis the risk factors for the death of patients in the mechanical ventilation group.Results:(1)General information,laboratory examination,treatment,coronary angiography a-nd non-cardiac complications of mechanical ventilation group:(1)Compared to non-mechanical ventilation groups,patients with mechanical ventilat-on groups were older,and albumin,hemoglobin,the hemoglobin were decreased,the Killip grade the higher,the difference was statistically significant(P<0.05),and whit-e blood cell count,neutral granulocyte count,troponin T,brain natriuretic peptide,uri-c acid,urea,creatinine,AST,ALT,blood glucose increase,significantly difference sta-tistical significance(P<0.05).The patients with three vascular lesions and the left m-ain dried disease in the mechanical ventilation group were even much more,and the probability of repeated circulation of coronary artery lower(P<0.05).The application of vascular active drugs,the aortic balloon anti-loop(IABP),and Continuous Renal Replacement therapy(CRRT)significantly increased in the mechanical ventilation gr-oup(P<0.05).Total ischemic time and CCU/ICU stay were longer(P<0.05).Noncar-diac complications occurred in both groups,with acute renal failure,liver damage,an-d gastrointestinal bleedingsignificantly higher in the mechanically ventilated group th-n in the non-mechanically ventilated group(P<0.05).(2)Logistic regression analysis showed that Killip classiffication,glucose,neutrophil count,albumin,total ischemia time,BNP,and uric acid are predictors for patients with acute STEMI that need the support of mechanical ventilation treatment.(2)General information,laboratory examination,treatment,coronary angiography and non-cardiac complications of the dead patients in the mechanical ventilation group:(1)Compared with the survivor group,patients in the death group were older,and the prevalence of hypertension was higher.The Killip level was higher(P<0.05);The dead patients with three vascular lesions and the left main dried disease were much more,no reverse ratio higher(P<0.05),and urea,lactic acid,troponin T(peak),significantly were higher(P<0.05),and PH,HCO3~-significantly lower(P<0.05).Dead patients with ischemic stroke were much more(P<0.05).(2)Logistic regression analysis showed that age and lactic acid were independent risk factors for the death of patients within 28 days in the mechanical ventilation group.Conclusion:(1)The heart function was worse,blood flow dynamics more unstable of the patients with acute STEMI that need the support of mechanical ventilation treatment,there were more complications,worse prognosis,higher mortality.(2)Logistic regression analysis showed that Killip classiffication,glucose,neutrophil count,albumin,total ischemia time,BNP,and uric acid are risk factors for patients with acute STEMI that need the support of mechanical ventilation treatment.(3)Age,lactic acid is an independent risk factor for the death of patients within 28days in the mechanical ventilation group. |
PDF Full Text Request