摘要
目的 探讨急性心肌梗死（AMI）患者院内死亡的危险因素.方法 回顾性分析我院2012-2015年232例AMI患者的临床资料,根据预后将其分为存活组209例和死亡组23例,比较两组患者的临床资料,采用多因素Logistic回归分析AMI患者院内死亡的危险因素.结果 AMI患者的总死亡率为9.9%（23/232）,女性死亡率为17.6%（12/68）,男性死亡率为6.7%（11/164）.与存活组相比,死亡组女性和Killip心功能Ⅲ-Ⅳ级患者比例高、年龄大（P〈0.05）.死亡组患者入院时RBC计数、Hb、肌酸激酶（CK）及CK同工酶（CK-MB）低于存活组,尿素氮、肌酐、尿酸及B型钠尿肽（BNP）高于存活组,差异均有统计学意义（P〈0.05）;两组患者WBC计数、中性粒细胞计数、PLT、电解质及血脂比较,差异均无统计学意义（P〉0.05）.死亡组广泛前壁心肌梗死患者比例明显高于存活组,接受经皮冠状动脉介入（PCI）术治疗患者比例明显低于存活组,差异均有统计学意义（P〈0.05）,两组之间梗死类型及其余部位心肌梗死患者比例比较,差异均无统计学意义（P〉0.05）.死亡组的死亡原因包括：心源性休克或心力衰竭（17例,73.91%）、心脏室壁瘤破裂（1例,4.34%）、心脏骤停（3例,13.04%,其中室颤1例、心室停顿2例）、缺血性脑卒中（2例,8.71%）.Logistic回归分析结果显示,广泛前壁心肌梗死、室颤和心源性休克是AMI患者院内死亡的危险因素,而PCI治疗是其保护因素.结论 广泛前壁心肌梗死、室颤和心源性休克是AMI患者院内死亡的危险因素,而早期行PCI术对降低院内死亡率有重要意义.
Objective To analyze the risk factors of in-hospital death in patients with acute myocardial infarction（AMI）.Methods The clinical data of 232 patients with AMI in our hospital from 2012 to 2015 were reviewed.All the patients were divided into survival group（209 cases） and death group（23 cases） according to the prognosis and to compare clinical data of the two groups.Multivariate Logistic regression analysis was conducted to analyze the risk factors of in-hospital death in patients with AMI.Results The overall death rate of patients with AMI was 9.9%（23/232）,with female death rate of 17.6%（12/68） and male death rate of 6.7%（11/164）.Compared with the survival group,rates of female and Killip heart function Ⅲ to Ⅳ were higher and patients were older in death group（P〈0.05）.RBC count,Hb,creatine kinase（CK） and CK-MB of admission in death group were lower than survival group,but urea nitrogen,creatinine and uric acid were higher（P〈0.05）.There was no significant difference in WBC count,neutrophil count,PLT count,electrolytes and blood lipids between the two groups（P〉0.05）.Rates of extensive anterior wall myocardial infarction patients in death group was higher than survival group,but rates of patients received percutaneous coronary intervention（PCI） was lower with statistically significant difference（P〈0.05）.There were no significant differences in the infarct type and rates of patients with the rest parts myocardial infarction between the two groups（P〉0.05）.The causes of death in death group included cardiogenic shock or heart failure （17 cases,73.91%）,ventricular aneurysm rupture（1 case,4.34%）,cardiac arrest （3 cases,13.04%,1 cases of ventricular fibrillation and 2 cases of ventricular standstill）,ischemic stroke （2 cases,8.71%）.Results of Logistic regression analysis showed that extensive anterior wall myocardial infarction,ventricular fibrillation and cardiogenic shock were the risk factors of in-hospital death in patients with AMI,whilet PCI therapy was the protective factor.Conclusion Extensive anterior wall myocardial infarction,ventricular fibrillation and cardiogenic shock are the risk factors of in-hospital death in patients with AMI,and early PCI therapy is important to reduce rates of in-hospital death.
出处
《临床内科杂志》
CAS
2017年第4期247-250,共4页
Journal of Clinical Internal Medicine
关键词
急性心肌梗死
院内死亡
危险因素
Acute myocardial Infarction
In-hospital death
Risk factors
