343例急性心肌梗塞预后因素探讨

Analysis of the prognostic factors in 343 patients of acute myocardial infarction

将１９８４～１９９３年因急性心肌梗塞（ＡＭＩ）住院的３４３例患者分为甲组（年龄≥６０岁）及乙组（年龄＜６０岁）进行分析。结果：甲乙２组死亡率分别为１６．５９％及５％（Ｐ＜０．０１）。在甲乙２组中因广泛前壁加２处以上梗塞死亡者的死亡率均明显高于存活者（Ｐ＜０．０１）；严重心律失常在甲乙２组死亡者中分别占６４．８６％、１００％，存活者占２４．１９％、３１．５８％（Ｐ＜０．００１）；Ⅲ°以上泵衰竭死亡者为５９．４６％、８３．３３％，存活者为２５．８１％、１７．５５％（Ｐ均＜０．００１）；并存２种以上疾病死亡者为５１．３５％、１６．６７％，存活者２．６９％、０％（Ｐ＜０．００１）。年龄、梗塞部位与面积大小、严重心律失常、泵衰竭及合并症等因素仍是当前影响ＡＭＩ预后的主要因素。

43 inpatients of acute myocardial infarction(AMI), admitted in 1984 to 1993, were divided into two groups according to the ages: group A(≥60 years of age)and group B(<60 years of age), for the analysis of prognostic factors. The mortality of group A was 16 59% and group B, 5%( P <0 01), and there was no correlation to sex. In both group A and B, extensive anterior myocardial infarction or infarction of more than two sites was found to be more in the patients who died than in the survival ones ( P <0 01). The rate of severe arrhythmia in patients who died was 64 86%(group A) and 100% (group B); in the survival patients, it was 24 19% and 31 58%,respectively. The rate of severe pump failure(more than Ⅲ°)in the patients who died was 59 46%(group A)and 83 33%(group B); in the survival, it was 25 81% and 17 55%,respectively ( P <0 001). The rate of coexisting diseases was 51 35%(group A)and 16 67%(group B)in the patients who died; 2 69% and 0% in the survival( P <0 001). In conclusion, the major prognostic factors of AMI were as followings:the patients age, and the existence of extensive infarction,severe arrhythmia, severe pump failure and coexisting diseases.