急性心肌梗塞并高血压患者近期预后

Observation of Short-term Prognosis on Hypertension Complicated with Acute Myocardial Infarction

探讨高血压对急性心肌梗塞（ＡＭＩ）患者近期预后的影响。方法７７例经监护病房确诊的ＡＭＩ患者，按是否合并高血压分为Ａ组（合并组４１例）和Ｂ组（不合并组３６例），对比分析其梗塞前左室肥大发生率、住院期间并发症及死亡率。结果左室肥大发生率：Ａ组７３．２％，Ｂ组２２．２％；梗塞后Ａ／Ｅ值增高：Ａ组１．７５±０．４３，Ｂ组１．１５±０．４８；泵衰竭发生率：Α组３１．７％，Β组５．６％。以上三项Α组均高于Β组，有非常显著差异（Ｐ＜０．０１）。左室重塑发生率及死亡率：Α组（４３．９％及３１．７％）高于Β组（１９．４％及１１．１％），有显著差异（Ｐ＜０．０５）。梗塞扩展发生率及严重心律失常发生率Ａ组高于Ｂ组，但无统计学差异。结论Α组近期预后比Β组差，提示高血压是影响ＡＭＩ预后的一个高危因素。

Aim\ To study the effect of shortterm prognosis in hypertensive patients with acute myocardial infarction(AMI).\ Methods\ According to whether complicated with essential hypertension(EH),seventyseven cases of AMI patients were divided into two groups: fortyone AMI patients in group A with EH and thirtysix AMI patients in group B without EH.\ The prevalance of left ventricular hypertrophy before AMI,the complications and mortality during hospitalization were analyzed.\ Results\ The incidences of left ventricular hypertrophy(732%) and heart failure(317%) in group A were significantly higher than those in group B(222%,56%,P<001).\ A/E of group A(175±043) was also significantly higher than that of group B(115±048,P<001).\ The mortality(317%) were markedly higher in group A than those in group B(194%,111%,P<005).\ The incidences of infarction extension in group A also greater than that in group B,but is not significant.\ Conclusion\ Hypertension is a risk factor affecting the prognosis of AMI.