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合并慢性阻塞性肺病对急性心肌梗死患者近期预后的影响 被引量:2

Influence of complicating chronic obstructive pulmonary disease on short-term prognosis in patients with acute myocardial infarction
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摘要 目的:探讨合并慢性阻塞性肺病(COPD)对急性心肌梗死(AMI)患者近期预后的影响。方法纳入2006年6月~2012年10月广西医科大学附属玉林市第一人民医院AMI患者92例,其中59例患者合并COPD归入AMI+COPD组,其余33例不合并COPD的患者归入AMI组,所有患者均行介入治疗处理罪犯血管。比较入组时两组患者AMI部位和罪犯血管支数以及左室收缩功能[包括左室射血分数(LVEF)和左室舒张末内径(LVEDD)],同时对所有患者进行3个月随访,观察两组不良事件(包括肺部感染、心律失常、心力衰竭、心源性休克、呼吸衰竭和死亡)的发生率。结果两组不同心肌梗死部位所占比例以及罪犯血管支数无统计学差异(P>0.05);与AMI组相比,AMI+COPD组LVEDD值更高[(59.6±6.4) mmvs.(42.8±3.7)mm],LVEF水平更低[(46.16±8.3)%vs.(59.25±7.2)%],差异均有统计学意义(P<0.05);同时AMI+COPD发生肺部感染(33.90%vs.12.12%)、心律失常(39.98%vs.27.27%)、心力衰竭(15.25%vs.6.06)、呼吸衰竭(22.03%vs.9.09%)、心源性休克(10.17%vs.3.03%)、死亡(8.47%vs.3.03%)的几率均高于AMI组,差异有统计学意义(P<0.05)。结论 COPD会进一步导致AMI患者心功能恶化,使其近期预后更差。 Objective To investigate the influence of complicating chronic obstructive pulmonary disease (COPD) on short-term prognosis in the patients with acute myocardial infarction (AMI).Methods The patients (n=92) were chosen from First People’s Hosptal of Yulin City affiliated to Guangxi Medical University from Jun. 2006 to Oct. 2012, and among them 59 with complicating COPD were included into AMI+COPD group and other 33 without COPD were included into AMI group. All patients were given intervention treatment for treating culprit vessels. The locations of AMI, count of culprit vessels and left ventricular systolic function (including LVEF and LVEDD) were compared between two groups. All patients were followed up for 3 months and the incidence of major adverse cardiovascular events (MACE) was observed in two groups (including pulmonary infection, arrhythmia, heart failure, cardiac shock, respiratory failure and death).Results There were no differences in proportion of different AMI locations and count of culprit vessels between two groups (P〉0.05). LVEDD was higher [(59.6±6.4)mmvs. (42.8±3.7)mm], LVEF was lower [(46.16±8.3)%vs. (59.25±7.2)%] in AMI+COPD group compared with AMI group(P〈0.05). In AMI+COPD group, the incidences of pulmonary infection (33.90%vs. 12.12%), arrhythmia (39.98%vs. 27.27%), heart failure (15.25%vs. 6.06), respiratory failure (22.03%vs. 9.09%), cardiogenic shock (10.17%vs. 3.03%) and death (8.47%vs. 3.03%) were all higher than those in AMI group (P〈0.05).Conclusion COPD can induce cardiac dysfunction and poorer prognosis in AMI patients.
作者 徐忠武
出处 《中国循证心血管医学杂志》 2013年第6期639-640,共2页 Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词 慢性阻塞性肺病 急性心肌梗死 近期预后 Chronic obstructive pulmonary disease Acute myocardial infarction Short-term prognosis
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