摘要
目的分析影响急性ST段抬高型心肌梗死（STEMI）患者住院期间预后的危险因素。方法回顾性分析我院急诊科确诊STEMI患者的临床资料,根据住院期间是否发生主要不良心血管事件将患者分为住院期间不良预后组和住院期间无不良预后组,通过logistic回归分析寻找影响STEMI患者住院期间预后的独立危险因素。结果共有436例患者纳入研究。其中住院期间不良预后组185例,无不良预后组251例。单因素分析发现：与无不良预后组比较,不良预后组患者年龄更大,男性、吸烟者比例更低,体重更轻,心率更快,收缩压和舒张压更低,心肌酶、肌酐和血糖更高,血红蛋白、LVEF更低,前壁梗死、Killip 2-4级、既往患糖尿病比例更高（P〈0.05）。logistic回归分析显示Killip 2-4级、既往患糖尿病是STEMI患者住院期间不良预后的危险因素,LVEF升高则是住院期间不良预后的保护因素,三者比值比分别为3.109 0、2.552 0和0.960 8（P〈0.05）。结论心功能差、既往患糖尿病患者发生住院期间不良预后风险大。
Objective To analyze the risk factors of the acute ST segment elevation myocardial infarction （ STE- MI）. Methods The clinical data of STEMI patients admitted to the emergency room were analyzed retrospectively for in- dependent risk factors for the prognosis of STEMI using logistic regression test. Results Four hundred and thirty six patients were recruited and divided into adverse outcome group and no adverse outcome group. Compared with the no adverse outcome group, the patients in the adverse group were older, with lower proportion of male and smoker, lower weight, faster heart rate, lower SBP and DBP, higher CPK, higher creatine, higher glucose, lower LVEF, and higher proportions of anterior myocardial infarction, Killip grade 2 - 4, hypertension, coronary heart disease, stroke and hyperlipidaemia （P 〈 0. 05 ）. Logistic regression test showed that glucose and Killip grade 2 - 4 were risk factors of adverse prognosis in STEMI, while high LVEF as protective factor. Conclusion Glucose and Killip grade 2 - 4 are risk factor of adverse prognosis of STEMI, while high LVEF as protective factor.
出处
《广东医学》
CAS
CSCD
北大核心
2014年第24期3817-3820,共4页
Guangdong Medical Journal
基金
广州市医药卫生科技一般引导项目(编号:20131A011148)
广州市医学重点学科建设项目(编号:穗卫科[2013]21号-11)
关键词
急性ST段抬高型心肌梗死
危险因素
预后
ST segment elevation myocardial infarction
risk factors
adverse outcome
作者简介
通信作者。E-mail：cxhgz168@126．com
