Chinese General Practice ›› 2023, Vol. 26 ›› Issue (27): 3397-3402.DOI: 10.12114/j.issn.1007-9572.2023.0126
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Received:
2022-10-18
Revised:
2023-03-23
Published:
2023-09-20
Online:
2023-03-30
Contact:
ZHAO Xiaoyan
通讯作者:
赵晓燕
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0126
组别 | 例数 | 年龄(岁) | 性别(男/女) | BMI〔M(P25,P75),kg/m2〕 | 吸烟史〔例(%)〕 | 饮酒史〔例(%)〕 | 高血压史〔例(%)〕 | 糖尿病史〔例(%)〕 | STEMI 〔例(%)〕 | 上机前心搏骤停〔例(%)〕 |
---|---|---|---|---|---|---|---|---|---|---|
生存组 | 27 | 53.3±12.2 | 22/5 | 26.8(23.2,28.4) | 17(63.0) | 11(40.7) | 10(37.0) | 9(33.3) | 21(77.8) | 20(74.1) |
死亡组 | 22 | 61.9±13.7 | 19/3 | 26.0(24.0,26.8) | 14(63.6) | 7(31.8) | 13(59.1) | 6(27.3) | 16(72.7) | 12(54.5) |
检验统计量值 | 2.317a | — | 0.784 | 0.002b | 0.415b | 2.367b | 0.210b | 0.167b | 2.040b | |
P值 | 0.025 | 0.715 | 0.433 | 0.961 | 0.519 | 0.124 | 0.647 | 0.683 | 0.153 | |
组别 | 梗死部位〔例(%)〕 | LVEF (%) | 肌酐〔M(P25,P75),μmoI/L〕 | 尿酸(μmoI/L) | 天冬氨酸氨基转移酶〔M(P25,P75),U/L〕 | 丙氨酸氨基转移酶〔M(P25,P75),U/L〕 | ||||
前壁 | 下壁 | 高侧壁 | ||||||||
生存组 | 16(59.3) | 13(48.1) | 3(11.1) | 31.9±13.2 | 102(79,120) | 449.4±155.4 | 96(58,236) | 210(79,425) | ||
死亡组 | 15(68.2) | 10(45.5) | 1(4.5) | 33.6±11.4 | 135(97,182) | 501.7±152.1 | 65(36,339) | 97(29,627) | ||
检验统计量值 | 0.415b | 0.035b | — | 0.479a | 2.020 | 1.184a | 1.136 | 0.593 | ||
P值 | 0.519 | 0.851 | 0.617 | 0.634 | 0.043 | 0.242 | 0.256 | 0.553 | ||
组别 | 三酰甘油〔M(P25,P75),mmol/L〕 | 低密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 白蛋白〔M(P25,P75),g/L〕 | Tn-I峰值〔M(P25,P75),μg/L〕 | NT-proBNP峰值〔M(P25,P75),ng/L〕 | 罪犯血管〔例(%)〕 | ||||
左主干或左前降支 | 左回旋支或右冠状动脉 | |||||||||
生存组 | 1.24(0.70,2.73) | 1.53(0.90,2.66) | 35.4(29.5,38.1) | 10.0(3.5,25.0) | 2 980(1 370,5 940) | 11(40.7) | 16(59.3) | |||
死亡组 | 1.10(0.85,1.51) | 1.85(1.56,2.48) | 34.0(31.0,38.6) | 10.0(4.3,19.8) | 5 175(2 032,15 245) | 17(77.3) | 5(22.7) | |||
检验统计量值 | 0.804 | 0.945 | 0.503 | 0.303 | 1.377 | 6.606b | ||||
P值 | 0.421 | 0.345 | 0.615 | 0.762 | 0.169 | 0.010 | ||||
组别 | PCI术后血流≤TIMI 2级〔例(%)〕 | IABP 〔例(%)〕 | CRRT 〔例(%)〕 | 临时起搏器〔例(%)〕 | 并发症〔例(%)〕 | |||||
脑出血 | 消化道出血 | 肺部感染 | 下肢静脉血栓 | 下肢缺血 | 急性肾损伤 | |||||
生存组 | 2(7.4) | 12(44.4) | 7(25.9) | 4(14.8) | 2(7.4) | 8(29.6) | 19(70.4) | 6(22.2) | 4(14.8) | 8(29.6) |
死亡组 | 2(9.1) | 11(50.0) | 13(59.1) | 5(22.7) | 2(9.1) | 6(27.3) | 19(86.4) | 2(9.1) | 3(13.6) | 14(63.6) |
检验统计量值 | — | 0.150b | 5.520b | — | — | 0.033b | — | — | — | 5.667b |
P值 | 1.000 | 0.698 | 0.019 | 0.713 | 1.000 | 0.856 | 0.303 | 0.269 | 1.000 | 0.017 |
组别 | 上机24 h液体总入量(mL) | 上机24 h液体总出量(mL) | 24 h液体平衡〔M(P25,P75),mL/kg〕 | 上机前乳酸(mmol/L) | 上机24 h乳酸〔M(P25,P75),mmol/L〕 | 24 h乳酸清除率〔M(P25,P75)〕 | ||||
生存组 | 5 476±1 963 | 3 831±1 996 | 18.0(9.3,33.3) | 9.8±4.1 | 2.4(1.6,2.8) | 0.76(0.64,0.83) | ||||
死亡组 | 6 162±2 048 | 3 464±1 474 | 29.3(21.3,45.3) | 9.3±4.5 | 3.9(2.2,4.6) | 0.58(0.41,0.76) | ||||
检验统计量值 | 1.195a | 0.716a | 2.241 | 0.370a | 2.084 | 2.472 | ||||
P值 | 0.238 | 0.477 | 0.025 | 0.713 | 0.037 | 0.013 |
Table 1 Comparison of baseline data between the two groups
组别 | 例数 | 年龄(岁) | 性别(男/女) | BMI〔M(P25,P75),kg/m2〕 | 吸烟史〔例(%)〕 | 饮酒史〔例(%)〕 | 高血压史〔例(%)〕 | 糖尿病史〔例(%)〕 | STEMI 〔例(%)〕 | 上机前心搏骤停〔例(%)〕 |
---|---|---|---|---|---|---|---|---|---|---|
生存组 | 27 | 53.3±12.2 | 22/5 | 26.8(23.2,28.4) | 17(63.0) | 11(40.7) | 10(37.0) | 9(33.3) | 21(77.8) | 20(74.1) |
死亡组 | 22 | 61.9±13.7 | 19/3 | 26.0(24.0,26.8) | 14(63.6) | 7(31.8) | 13(59.1) | 6(27.3) | 16(72.7) | 12(54.5) |
检验统计量值 | 2.317a | — | 0.784 | 0.002b | 0.415b | 2.367b | 0.210b | 0.167b | 2.040b | |
P值 | 0.025 | 0.715 | 0.433 | 0.961 | 0.519 | 0.124 | 0.647 | 0.683 | 0.153 | |
组别 | 梗死部位〔例(%)〕 | LVEF (%) | 肌酐〔M(P25,P75),μmoI/L〕 | 尿酸(μmoI/L) | 天冬氨酸氨基转移酶〔M(P25,P75),U/L〕 | 丙氨酸氨基转移酶〔M(P25,P75),U/L〕 | ||||
前壁 | 下壁 | 高侧壁 | ||||||||
生存组 | 16(59.3) | 13(48.1) | 3(11.1) | 31.9±13.2 | 102(79,120) | 449.4±155.4 | 96(58,236) | 210(79,425) | ||
死亡组 | 15(68.2) | 10(45.5) | 1(4.5) | 33.6±11.4 | 135(97,182) | 501.7±152.1 | 65(36,339) | 97(29,627) | ||
检验统计量值 | 0.415b | 0.035b | — | 0.479a | 2.020 | 1.184a | 1.136 | 0.593 | ||
P值 | 0.519 | 0.851 | 0.617 | 0.634 | 0.043 | 0.242 | 0.256 | 0.553 | ||
组别 | 三酰甘油〔M(P25,P75),mmol/L〕 | 低密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 白蛋白〔M(P25,P75),g/L〕 | Tn-I峰值〔M(P25,P75),μg/L〕 | NT-proBNP峰值〔M(P25,P75),ng/L〕 | 罪犯血管〔例(%)〕 | ||||
左主干或左前降支 | 左回旋支或右冠状动脉 | |||||||||
生存组 | 1.24(0.70,2.73) | 1.53(0.90,2.66) | 35.4(29.5,38.1) | 10.0(3.5,25.0) | 2 980(1 370,5 940) | 11(40.7) | 16(59.3) | |||
死亡组 | 1.10(0.85,1.51) | 1.85(1.56,2.48) | 34.0(31.0,38.6) | 10.0(4.3,19.8) | 5 175(2 032,15 245) | 17(77.3) | 5(22.7) | |||
检验统计量值 | 0.804 | 0.945 | 0.503 | 0.303 | 1.377 | 6.606b | ||||
P值 | 0.421 | 0.345 | 0.615 | 0.762 | 0.169 | 0.010 | ||||
组别 | PCI术后血流≤TIMI 2级〔例(%)〕 | IABP 〔例(%)〕 | CRRT 〔例(%)〕 | 临时起搏器〔例(%)〕 | 并发症〔例(%)〕 | |||||
脑出血 | 消化道出血 | 肺部感染 | 下肢静脉血栓 | 下肢缺血 | 急性肾损伤 | |||||
生存组 | 2(7.4) | 12(44.4) | 7(25.9) | 4(14.8) | 2(7.4) | 8(29.6) | 19(70.4) | 6(22.2) | 4(14.8) | 8(29.6) |
死亡组 | 2(9.1) | 11(50.0) | 13(59.1) | 5(22.7) | 2(9.1) | 6(27.3) | 19(86.4) | 2(9.1) | 3(13.6) | 14(63.6) |
检验统计量值 | — | 0.150b | 5.520b | — | — | 0.033b | — | — | — | 5.667b |
P值 | 1.000 | 0.698 | 0.019 | 0.713 | 1.000 | 0.856 | 0.303 | 0.269 | 1.000 | 0.017 |
组别 | 上机24 h液体总入量(mL) | 上机24 h液体总出量(mL) | 24 h液体平衡〔M(P25,P75),mL/kg〕 | 上机前乳酸(mmol/L) | 上机24 h乳酸〔M(P25,P75),mmol/L〕 | 24 h乳酸清除率〔M(P25,P75)〕 | ||||
生存组 | 5 476±1 963 | 3 831±1 996 | 18.0(9.3,33.3) | 9.8±4.1 | 2.4(1.6,2.8) | 0.76(0.64,0.83) | ||||
死亡组 | 6 162±2 048 | 3 464±1 474 | 29.3(21.3,45.3) | 9.3±4.5 | 3.9(2.2,4.6) | 0.58(0.41,0.76) | ||||
检验统计量值 | 1.195a | 0.716a | 2.241 | 0.370a | 2.084 | 2.472 | ||||
P值 | 0.238 | 0.477 | 0.025 | 0.713 | 0.037 | 0.013 |
指标 | 单因素Logistic回归分析 | 多因素Logistic回归分析 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
β | SE | Wald χ2值 | OR(95%CI) | P值 | β | SE | Wald χ2值 | OR(95%CI) | P值 | |
年龄 | 0.053 | 0.025 | 4.579 | 1.055(1.005,1.108) | 0.032 | 0.097 | 0.046 | 4.570 | 1.102(1.008,1.205) | 0.033 |
肌酐 | 0.014 | 0.007 | 3.621 | 1.014(0.999,1.029) | 0.057 | |||||
罪犯血管为左主干或左前降支 | 1.598 | 0.642 | 6.198 | 4.945(1.405,17.407) | 0.013 | 2.166 | 1.108 | 3.820 | 8.722(0.994,76.526) | 0.051 |
CRRT | 1.418 | 0.617 | 5.276 | 4.127(1.231,13.835) | 0.022 | 1.102 | 1.220 | 0.815 | 3.009(0.275,32.869) | 0.367 |
急性肾损伤 | 1.425 | 0.612 | 5.426 | 4.156(1.253,13.782) | 0.020 | 2.766 | 1.278 | 4.685 | 15.888(1.299,194.388) | 0.030 |
上机24 h乳酸 | 0.509 | 0.215 | 5.599 | 1.664(1.091,2.537) | 0.018 | |||||
24 h液体平衡 | 0.044 | 0.019 | 5.054 | 1.045(1.006,1.085) | 0.025 | 0.082 | 0.040 | 4.133 | 1.085(1.003,1.174) | 0.042 |
24 h乳酸清除率 | -3.711 | 1.539 | 5.812 | 0.024(0.001,0.499) | 0.016 | -10.495 | 4.158 | 6.370 | 0.001(0,0.096) | 0.012 |
Table 2 Logistic regression analysis of the influencing factors of the 30-d post-ECMO outcomes in AMI patients combined with CS
指标 | 单因素Logistic回归分析 | 多因素Logistic回归分析 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
β | SE | Wald χ2值 | OR(95%CI) | P值 | β | SE | Wald χ2值 | OR(95%CI) | P值 | |
年龄 | 0.053 | 0.025 | 4.579 | 1.055(1.005,1.108) | 0.032 | 0.097 | 0.046 | 4.570 | 1.102(1.008,1.205) | 0.033 |
肌酐 | 0.014 | 0.007 | 3.621 | 1.014(0.999,1.029) | 0.057 | |||||
罪犯血管为左主干或左前降支 | 1.598 | 0.642 | 6.198 | 4.945(1.405,17.407) | 0.013 | 2.166 | 1.108 | 3.820 | 8.722(0.994,76.526) | 0.051 |
CRRT | 1.418 | 0.617 | 5.276 | 4.127(1.231,13.835) | 0.022 | 1.102 | 1.220 | 0.815 | 3.009(0.275,32.869) | 0.367 |
急性肾损伤 | 1.425 | 0.612 | 5.426 | 4.156(1.253,13.782) | 0.020 | 2.766 | 1.278 | 4.685 | 15.888(1.299,194.388) | 0.030 |
上机24 h乳酸 | 0.509 | 0.215 | 5.599 | 1.664(1.091,2.537) | 0.018 | |||||
24 h液体平衡 | 0.044 | 0.019 | 5.054 | 1.045(1.006,1.085) | 0.025 | 0.082 | 0.040 | 4.133 | 1.085(1.003,1.174) | 0.042 |
24 h乳酸清除率 | -3.711 | 1.539 | 5.812 | 0.024(0.001,0.499) | 0.016 | -10.495 | 4.158 | 6.370 | 0.001(0,0.096) | 0.012 |
预测指标 | AUC | 95%CI | 最佳截断值 | 灵敏度 | 特异度 | P值 |
---|---|---|---|---|---|---|
24 h液体平衡 | 0.688 | (0.539,0.812) | 22.2 mL/kg | 0.773 | 0.630 | 0.015 |
24 h乳酸清除率 | 0.707 | (0.560,0.828) | 0.63 | 0.546 | 0.815 | 0.006 |
联合指标 | 0.847 | (0.715,0.934) | 0.864 | 0.778 | <0.001 |
Table 3 Predictive value of 24-h liquid balance,24-h lactic acid clearance and their combination for 30-d post-ECMO death in AMI patients combined with CS
预测指标 | AUC | 95%CI | 最佳截断值 | 灵敏度 | 特异度 | P值 |
---|---|---|---|---|---|---|
24 h液体平衡 | 0.688 | (0.539,0.812) | 22.2 mL/kg | 0.773 | 0.630 | 0.015 |
24 h乳酸清除率 | 0.707 | (0.560,0.828) | 0.63 | 0.546 | 0.815 | 0.006 |
联合指标 | 0.847 | (0.715,0.934) | 0.864 | 0.778 | <0.001 |
Table 1 ROC curve of 24-h fluid balance,24-h lactic acid clearance and their combination predicting 30-d post-ECMO death in AMI patients combined with CS
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