目的 探讨红细胞压积的变化对急性ST段抬高型心肌梗死 (STEMI) 接受急诊经皮冠状动脉支架植入术患者的临床预后的影响.方法 连续性纳入我院心肌梗死绿色通道收治行急诊支架植入患者603例, 根据住院期间红细胞压积的变化分为A组 (红细胞压积降低组, 255例) 和B组 (红细胞压积升高组, 348例) .收集两组患者资本资料、手术相关信息、化验室资料、住院期间临床事件、1个月内临床事件以及1年内临床事件并予以统计分析.结果 A组年龄大于B组[ (60.33±11.06) 岁vs (58.44±10.88) 岁, P＜0.05], B组脑血管病史发生率高与A组 (13.50％vs 8.24％, P＜0.05) , A组梗死相关动脉中血栓病变发发生率高于B组 (97.25％vs 88.51％, P＜0.05) .支架植入后最终TIMI血流:3级血流A组较B组高 (85.88％vs 79.02％, P＜0.05) .A组较B组住院期间心源性死亡发生率低 (0 vs 2.01％, P＜0.05) ;出院1年内LVEF低于B组[ (55.53±6.42) ％vs (57.19±6.82) ％, P＜0.05];出院1年室壁运动异常发生率高于B组 (92.88％vs 87.69％, P＜0.05) .结论 住院期间红细胞压积升高增加STEMI患者在院期间心源性死亡的发生, 红细胞压积降低预示着心功能的下降及室壁运动功能受损.%Objective To investigate the effect of changes in hematocrit on the clinical outcome of patients undergoing emergency percutaneous coronary stenting in patients with acute ST-segment elevation myocardial infarction (STEMI) . Methods 603 patients with emergency stent implantation were enrolled in the green channel of myocardial infarction in our hospital. According to the changes of hematocrit during hospitalization, they were divided into group A (red blood cell reduction group, 255 cases) and group B (increased hematocrit, 348 cases) . Capital data, surgical related information, laboratory data, clinical events during hospitalization, clinical events within 1 month, and clinical events within 1 year were collected and statistically analyzed. Results The age of group A was higher than that of group B [ (60.33 ±11.06) years old vs (58.44±10.88) years old, P ＜0.05]. The incidence of cerebrovascular disease in group B was higher than that in group A (13.50％ vs 8.24％, P ＜0.05) . The incidence of thrombosis in infarct-related arteries in group A was higher than that in group B (97.25％ vs 88.51％, P ＜0.05) . Final TIMI blood flow after stent implantation: Grade 3 blood flow was higher in group A than in group B (85.88％ vs 79.02％, P＜0.05) . The incidence of cardiac death was lower in group A than in group B (0 vs 2.01％, P＜0.05) ; LVEF was lower in group than in group B within 1 year [ (55.53 ±6.42) ％ vs (57.19±6.82) ％, P＜0.05];the incidence of abnormal wall motion at 1 year was higher than that of group B (92.88％ vs 87.69％, P ＜0.05) . Conclusion Increased hematocrit during hospitalization increases cardiac death during hospitalization in STEMI patients. Decreased hematocrit indicates a decline in cardiac function and impaired wall motion.
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