急性心肌梗死患者近期预后模型的建立

Short-term prognostic factors and a predictive model inpateints with acute myocardial infarction

目的:研究急性心肌梗死(AMI)患者血清学指标及年龄、性别、心电图定位等因素与近期预后的相关性并建立预后模型。方法:收集115例急性ST段抬高型心肌梗死(STEMI)患者的常用血清学指标及年龄、性别、心电图定位等因素及近期预后情况,运用Logistic回归模型分析这些因素与近期预后的关系。结果:115例患者中好转组80例,死亡组35例,病死率30.43%(35/115)。单因素Logistic回归分析:年龄、D-二聚体、血尿素氮、血肌酐、血钙、血镁是影响AMI患者预后的相关因素。多因素Logistic回归分析AMI患者近期预后的独立危险因素有:年龄、D-二聚体、尿素氮。建立AMI预后判断模型P=1/(1+e-y),Y=-7.434+0.067×年龄+0.510×D-二聚体+0.148×尿素氮,其中P为患者预后的死亡概率,年龄取值实际岁数,D-二聚体、尿素氮为实测值。两组患者预后判断符合率为83.5%。结论:年龄、D-二聚体、血尿素氮是判断AMI预后的独立危险因素,可用于预后判断模型的构建。AMI预后判断模型P=1/(1+e-y),Y=-7.434+0.067×年龄+0.510×D-二聚体+0.148×尿素氮,能够较为准确地预测AMI患者的近期预后。

Objective： To study the influencing factors in short-term prognosis and a predictive model in patients with acute myocardial infarction （AMI）. Method： A total of 115 patients with STEMI were enrolled. We collected the factors as laboratory indicators, age, gender, ECG and the short-term prognosis in patients during hospitalized. Multivariate analysis was explored by logistic regression, and a predictive model was established. Result：Among these patients, 80 patients recovered, while 35 cases worsen or died. The case fatality rate was 30.43% （35/115）. Logistic regression analysis showed that the factors associated with prognosis of AMI were age, D-D, BUN, Cr, serum calcium, serum magnesium. The prognosis predicting model was P=l/（l＋e Y）, Y =-7. 434＋0. 067 X Age＋0. 510 X D-D＋0. 148 X BUN. Conclusion： Age, D-D, BUN are important influencing factors in prognosis of AMI. The model generated in this study can more aecuratly predict the short-term progno- sis in patients with AMI.