急性心肌梗死患者在院死亡独立危险因素的观察

Observation of on the independent risk factors of the mortality in hospitalized patients with acute myocardial infarction

目的回顾性分析2006～2008年于我院行经皮冠状动脉介入(PCI)治疗的急性心肌梗死(AMI)患者在院平均血糖水平与在院死亡的关系。方法单因素和多因素Logistic回归模型对平均血糖值、年龄等11个候选因素进行分析。结果单因素Logistic回归分析发现,在院平均血糖升高(Waldχ2=11.883,P=0.001)、增龄(Waldχ2=17.336,P=0.000)、低HDL-C血症(Waldχ2=4.024,P=0.045)可能是AMI患者在院死亡的危险因素,提示在院平均血糖值(Waldχ2=10.266,OR=1.69)、增龄(Waldχ2=13.604,OR=5.24)是AMI患者在院死亡的主要危险因素。结论在院平均血糖水平高、增龄是已行PCI治疗的AMI患者在院死亡的主要独立危险因素。

Objective To retrospectively study the relation between the average blood glucose levels and hospitalized mortality of the hospitalized patients with acute myocardial infarction （AMI） treated by percutaneous coronary intervention （PCI） in the duration from 2006 to 2008 in our hospital. Methods By using the univariate and multivariate logistic regression analyses, the 11 factors, including average blood glucose level, age, etc. , were applied to screen the possible risk factors of the mortality in patients hospitalized with AMI. Results In the univariate logistic regression analysis, it was discovered that the higher average blood glucose level （Wald X2=11. 883, P=0. 001）, aging （Wald X2= 17. 336, P= 0. 000）, and low HDL-C （Wald X2=4. 024, P=0. 045） were the potential predictors of mortality for patients hospitalized with AMI. The multivariate logistic regression analysis showed that both the higher average blood glucose level （Wald X2= 10. 266, OR= 1.69） and aging （Wald X2 = 13. 604, OR= 5.24） were the prominent risk factors for hospitalized death. Conclusion Both the higher average blood glucose level in hospital and aging are the prominent risk factors of the mortality in hospitalized patients with AMI treated by PCI.