影响急性ST段抬高型心肌梗死住院病死率因素分析

Analysis of the Factors to Influence the Hospital Mortality of STEMI Patients

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者的住院死亡情况,分析与住院病死率相关的影响因素。方法:收集2007年9月～2010年8月潍坊市人民医院心内一科402例急性心肌梗死患者的病历资料,比较病死组与存活组患者各项指标情况异同,分析与住院病死率相关的各项影响因素。结果:STEMI患者的住院病死率为8.0%(32/402)。STEMI住院死亡患者主要特点:年龄大,左室排血功能(LVEF)低,Kjllip分级高,肾功能不全,休克的发生率高,β-受体阻断药使用率低,接受经皮冠状动脉介入治疗率低。Binary logistic多元回归分析显示高龄、Killip分级高、β-受体阻断药使用率低是STEMI患者住院病死率的独立危险因素。结论:高龄、心功能Killip分级高、β-受体阻断药使用率对STEMI患者的住院期间病死率具有显著影响。

Objective： To investigate the hospital mortality of STEMI patients, and analyze its related risk factors. Method ： The data of 402 STEMI patients who were admitted in Weifang People＇ s Hospital from September 2007 to August 2010 were collected. The various factors that were associated with the in-hospital fatality rate were retrospectively analyzed. A statistical analysis was performed with SPSS version 16.0. Result： The in-hospital mortality of STEMI was 8.0% （32/ 402）. Its main characteristics included elder age, cardiac insufficiency （low LVEF） , kidney insufficiency, shock, less use of β-blocker and less interference therapy with PCI procedure. The logistic regression analysis revealed that age, high Killip classification and low use of β-blocker were independent hazardous factors of the in-hospital mortality of STEMI patients. Conclusion ： Age, high Killip classification, less use of β-blocker were the significant factors to affect the in-hospital fatality rate of STEMI patients.