性别对急性心肌梗死院内病死率的影响及相关因素分析

Effect of Gender on In-Hospital Mortality in Patients with Acute MyocardialInfarction and Its Relevant Factors

目的 :分析急性心肌梗死 (AMI)后男女患者院内病死率的差别及其影响因素。方法 :研究了536例A MI患者 (男379例 ,女157例 )的一般临床资料及住院期院内病死率。结果 :⑴平均年龄女性较男性大 ;合并糖尿病(DM )及高血压者女性较男性多 ;吸烟者男性较女性多 ;发病<6h就诊率及再灌注治疗 (静脉溶栓或直接PTCA)率女性较男性低 ;院内病死率女性明显高于男性 ,分别为14.01%及8.18%。⑵70岁以下组男女患者上述各项比较同上。⑶70岁及以上组高血压发生率女性仍高于男性 ,吸烟者男性仍高于女性 ,但DM发生率、发病<6h就诊率及再灌注治疗率及院内病死率间比较 ,男女患者差别无统计学意义。结论 :女性急性心肌梗死者较男性平均年龄大 ;70岁以下女性院内病死率高于男性 ,70岁及以上两性院内病死率相似 ;DM、就诊迟及再灌注治疗率低可能是70岁以下女性院内病死率高的主要原因。

Objective:To analyze the effect of gender on in-hospital mortality in patients with acute myocardial infarction(AMI)and its relevant factors.Methods:A retrospective study was performed through analyzing the clinical characteristics and in-hospital mortality in 536 patients(including 379 men and 157 women)with AMI.Results:(1)Women were older than men;women had more complications,such as diabetes mellitus(DM)and hypertension,than men;men smokers were more than women ones;fewer women were presented to hospital within 6 hours of the onset of chest pain and were treated with reperfusion(in-venous thrombolysis or PTCA)than men;the overall in-hospital mortality of women(14.01%)was higher than men(8.18%).(2)Below 70 years,things were the same as above.(3)Equal to or above 70 years,there was no sex-based difference regarding DM,duration from chest pain to hospital presentation,reperfusion treatment and in-hospital mortality.Conclusion:The women patients with AMI are older than men;the in-hospital mortality of women is higher than that of men below 70 years and is similar above or equal to 70 years;DM,later presentation in hospital and less reperfusion treatment are the possible causes that women below 70 years have a higher in-hospital mortality.