危重急性心肌梗死患者住院死亡的危险因素分析

Analysis of Risk Factors of Hospital Mortality in Patients With Severe Acute Myocardial Infarction

目的:探讨需要机械通气和/或主动脉球囊反搏支持治疗的危重急性心肌梗死患者住院死亡相关的危险因素。方法:回顾性调查我院收治的需要机械通气和/或主动脉球囊反搏支持治疗的危重心肌梗死患者115例,使用Logistic回归分析探讨危重急性心肌梗死患者住院死亡的危险因素。结果:115例患者中,康复出院42例,院内死亡73例,病死率63.48%。多因素分析表明前壁心肌梗死、左室射血分数严重减低(LVEF<35%)、血肌酐升高(Cr>133μmol/L)、血红蛋白降低(男性<120g/L,女性<110g/L)是住院死亡的独立危险因素。结论:需要机械通气和/或主动脉球囊反搏支持治疗的危重急性心肌梗死患者病死率高,前壁心梗、泵衰竭、肾功能不全、贫血是住院死亡的独立危险因素。

Objective： To investigate the outcome and risk factors of hospital mortality in patients with severe acute myocardial infarction requiting mechanical ventilation（MV） or intra-aortic balloon pump（IABP）,or both. Methods： One hundred and fifteen patients with acute myocardial infarction received MV, or IABP, or both were analyzed retrospectively. Risk factors and hospital mortality were analyzed by logistic regression in patients with severe acute myocardial infarction. Results： The total mortality of 115 patients was 63. 48%. Anterior myocardial infarction, low LVEF（〈0. 35）, high serum creatinine level （〉133 μmol/L） and reduced hemoglobin level （〈120 g/L in males, and〈 110 g/L in females）are the independent risk factors of hospital mortality. Conclusions： Patients with severe acute myocardial infarction requiring MV, or IABP,or both had a higher hospital mortality. Anterior myocardial infarction,pump failure, renal insufficiency, and anemia were independent risk factors for hospital mortality.