急性心肌梗死医院感染对病死率的影响

Effect of acute myocardiaIInfarction complicated with nosocomial infection on the mortality rate

目的探讨急性心肌梗死(Acute myocardial infarction,AMI)合并医院感染对病死率的影响,为其临床研究提供依据。方法共纳入40例入住医院心内科的AMI患者,积极给予相应的对症支持治疗措施,详细记录其相关信息,根据其是否发生医院感染分为感染组与非感染组两组,对两组患者的病死率进行统计分析;采用SPSS12.0软件包进行,计量资料经检验为正态分布且方差齐者采用(均数±标准差)表示,采用t检验,计数资料用百分数表示,组间比较用χ2检验。结果 40例AMI患者中有24例患者发生医院感染,感染率为60.0%,12例为呼吸道感染、7例为尿路感染、4例为口腔炎症、其他1例;感染组患者出院后3、6、12个月的死亡例数分别为5、4、3例均高于非感染组患者的0、1、2例,但比较差异无统计学意义;进一步统计发现,感染组患者病死率50.0%明显高于非感染组患者的18.8%,比较差异有统计学意义(P<0.05),其中感染组死亡12例中再发心肌梗死死亡9例占75.0%,猝死3例占25.0%,非感染组死亡3例均为再发心肌梗死死亡。结论 AMI合并医院感染能够明显增加患者的病死率,并增加了患者发生再次心肌梗死的风险,在临床工作中对于该类患者要积极注意其临床特征,病情好转出院需继续积极服用药物治疗,降低再次心肌梗死的发生风险,以期尽可能的避免死亡的发生。

OBJECTIVE To evaluate the effect of nosocomial infection on the prognosis of patients with acute myocardial infarction. METHODS Total of 40 cases of patients with acute myocardial infarction admitted to the department of cardiology, The corresponding support was given to treat the disease. detailed relevant information. was record According to ineidence of nosocomial infection, patients were divided into, the infection gronp and noinfection group. The statistical analysis was conducted with SPSS12. 0 softnare. RESULTS Arory 40 cases of patients with acute myocardial infarction, 24 patients emerged nosocomial infection, with the incidence rate of was 60.0%, of which 12 cases were respiratory tract infection, 7 cases were urinary tract infection, 4 cases were oral inflammation s case 1 case nas her. after 3rd,6th,12nd morth discharge in, the numbers of death infected mere cases respectively 5, 4, 3, which were higher than thot of moninfecon cases which 0, 1, 2, The difference wos not statistically significant （P〉0. 05）; were respectively 50. 0 % mortality of the infection group was significantly higher than 18.8% rmortalioy in ron infection group with has the statistically significant difference （P〈0. 05）. Among of 12 deoth cases .there were a case of infection, myocardial infarction, death 9 cases （75.0%）, 3 cases of sudden death. 3 detuh cases in nomifection be group reswtedfrom to again hair myocardial infarction. CONCLUSION Acute myocardial infarction moirtality can be significantly increase by nosocomial infection due to increased risk of myocardial infarction. More attention should be paid on clinical characteristics of the patients, which need to take artive medication, reduce the risks of the occurrence of myocardial infarction again in order to avoid the death.