实用临床医药杂志2024,Vol.28Issue(15) :43-48,53.DOI:10.7619/jcmp.20240498

新型冠状病毒感染合并急性心肌梗死患者的临床特点

Clinical characteristics of patients with acute myocardial infarction complicated with Coronavirus Disease 2019

喻澄 陈浩 董丰 李杏 刘钰龙
实用临床医药杂志2024,Vol.28Issue(15) :43-48,53.DOI:10.7619/jcmp.20240498

新型冠状病毒感染合并急性心肌梗死患者的临床特点

Clinical characteristics of patients with acute myocardial infarction complicated with Coronavirus Disease 2019

喻澄 1陈浩 1董丰 1李杏 1刘钰龙1
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作者信息

  • 1. 江南大学附属中心医院心血管内科,江苏无锡,214000
  • 折叠

摘要

目的 探讨新型冠状病毒感染合并急性心肌梗死患者的临床特征及预后结果.方法 回顾性选取76例急性心肌梗死患者为研究对象.根据是否合并新型冠状病毒感染,分为新冠组(n=42)与对照组(n=34).比较2组患者的一般临床情况、实验室检查指标、介入治疗特征、住院期间的并发症发生率以及预后.分析急性心肌梗死患者发生冠状动脉血栓性病变的独立影响因素.结果 新冠组舒张压、左心室射血分数和淋巴细胞计数低于对照组,脂蛋白a、C反应蛋白、血清铁蛋白、纤维蛋白原和D-二聚体高于对照组,差异有统计学意义(P<0.05).新冠组冠状动脉血栓病变、基线心肌梗死溶栓试验(TIMI)血流0~1级、血栓负荷分级4~5级、注射GP Ⅱb/Ⅲa和血栓抽吸者占比高于对照组,差异有统计学意义(P<0.05).多因素Logistic回归分析显示,新型冠状病毒感染、D-二聚体增高是急性心肌梗死患者发生冠状动脉血栓病变的独立危险因素.新冠组平均住院时间长于对照组,差异有统计学意义(P<0.05).随访6个月结果显示,新冠组主要不良心血管事件(MACEs)发生率高于对照组,差异有统计学意义(P=0.014).结论 新型冠状病毒感染合并急性心肌梗死患者的冠状动脉血栓负荷更高,预后更差.

Abstract

Objective To explore the clinical characteristics and prognostic outcomes of patients with acute myocardial infarction complicated by Coronavirus Disease 2019(COVID-19).Methods A retrospective study was conducted in 76 patients with acute myocardial infarction.Based on the pres-ence of COVID-19,they were divided into the COVID-19 group(n=42)and the control group(n=34).General clinical conditions,laboratory examination indicators,interventional treatment charac-teristics,incidence of complications during hospitalization and prognosis were compared between the two groups.Independent influencing factors for coronary thrombotic lesions in acute myocardial infarc-tion patients were analyzed.Results The diastolic blood pressure,left ventricular ejection fraction and lymphocyte count were significantly lower,while lipoprotein a,C-reactive protein,serum ferritin,fi-brinogen,and D-dimer were significantly higher in the COVID-19 group than those in the control group(P<0.05).The proportions of coronary thrombotic lesions,baseline TIMI flow of grade 0 to 1,thrombus burden of grade 4 to 5,use of GP Ⅱb/Ⅲa inhibitors and thrombus aspiration in the COVID-19 group were significantly higher than those in the control group(P<0.05).Multivariate Logistic regres-sion analysis revealed that COVID-19 and increased D-dimer were independent risk factors for coronary thrombotic lesions in acute myocardial infarction patients.The average length of hospital stay was sig-nificantly longer in the COVID-19 group than that in the control group(P<0.05).A 6-month follow-up showed that the incidence of major adverse cardiac events(MACEs)was significantly higher in the COVID-19 group than that in the control group(P=0.014).Conclusion Patients with acute myocardial infarction complicated by COVID-19 exhibit a higher coronary thrombus load and have a poor prognosis.

关键词

新型冠状病毒感染/D-二聚体/急性心肌梗死/血栓/冠状动脉

Key words

Coronavirus Disease 2019/D-dimer/acute myocardial infarction/thrombus/coronary artery

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基金项目

江苏省无锡市"双百"中青年医疗卫生拔尖人才项目(HB2023026)

出版年

2024
实用临床医药杂志
扬州大学,中国高校科技期刊研究会

实用临床医药杂志

CSTPCD
影响因子:1.543
ISSN:1672-2353
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