急性心肌梗死代谢危险因素累积效应分析

Cumulative effect of metabolism risk factors on acute mycardial infarction

目的研究急性心肌梗死（AMI）患者的代谢危险因素并评估其累积效应对预后的影响。方法调查398例AMl住院患者的高血压及糖代谢异常等代谢危险因素，具有3种或以上代谢危险因素的患者为A组，具有1种或2种的患者为B组，其余为c组。分析三组患者的临床特点、住院病死率，1年病死率及1年内心力衰竭及再次心肌梗死等心性事件的发生情况。结果A组108例，B组153例患者；A或B组Kiliip分级高、恶性心律失常发生率、住院病死率、1年内病死率以及1年内心性事件发生率高于c组，差异有统计学意义（P〈0．05或P〈0．01）；A组高血压、糖代谢紊乱、冠心病、血脂代谢紊乱多于B组（P〈0．01），Kiliip分级、恶性心律失常发生率、住院病死率、1年内病死率以及1年内心性事件发生率高于B组或c组，差异有统计学意义（P〈0．05或P〈0．01）。结论代谢危险因素是影响AMI患者预后的独立危险因素，代谢危险因素越多，预后越差。

Objective To investigate the metabolism al infarction（AMI） and the cumulative effect on the outcome. risk factors of patients with acute myocardi- Methods The metabolism risk factors of 398 patients with AMI received the conventional therapies were investigated, including hypertension, gly- cometabolism and dyslipidemia, etc. The patients with three or more metabolism risk factors were en- rolled in group A, while those with one or two metabolism risk factors were enroled in group B, and the others were enrolled in group C. The clinical characteristics, inhospital mortality, one year mortality and heart ocurrence rate in one year was analyzed. Results There were 153 patients in group B, and 108 patients in group A. Compared with groupC, patients in group A or group B were more prone to have ma- lignant arrhythmia and high Killip grade, and the inhospital, one year mortality and heart ocurrence rate were higher（ P 〈 0. 05 or P 〈 0. 01 ）. Compared with group B, patientsin group A were more prone to have hypertension disorder, glycometabolism, dyslipidemia and abdomen obese（P 〈 0. 01）. Compared with group B or group C, patients in group A were more prene to have more malignant arrhythmia and high Killip grade patients in, and the inhospital, one year mortality and heart ocurrence rate were higher （P 〈 0. 05 or P 〈 0. 01 ）. Conclusions The metabolism risk factors are all independent risk factors for the outcome of the patients with AMI, with more metabolism risk factors, the outcome is worse.