急性冠脉缺血综合征病人预后因素的评估

Assessment of Prognosis Factors of Patients With Acute Coronary Ischemic Syndrome

目的 :探讨急性冠脉缺血综合征患者的基本特征与预后因素的关系。方法 :入选 15 0例因急性缺血性胸痛而住院的患者 ,对其基本特征及接受不同治疗手段后 7d、6个月的病死率及重大心脏事件发生率进行问卷调查登记及电话随访 ,并做统计学分析。结果 :(1)入选患者平均年龄 (6 0 .9± 9.8)岁 ,其中男患占 5 5 .2 % ;诊断为不稳定心绞痛者 134人 ,占 89.3% ,非Q波心肌梗死者 15人 ,占 10 .0 % ;(2 )住院期间 ,行冠脉造影者 6 8人 ,其中接受PTCA治疗者 35人 ;住院期间 ,发生心肌梗死 11例 (占 7.3% ) ,出现心衰 8例 (5 .3% ) ,死亡 5例 (3.3% ) ;(3)与 7d病死率独立相关的预后因素依次为心肌梗死病史、住院期间出现再梗塞 ;(4 )与 6个月病死率独立相关的预后因素依次为载脂蛋白B >1.10 g/L、年龄 >6 5岁、心肌梗死病史及再梗塞病史。 结论 :急性冠脉缺血综合征的危险性可以通过其基本特征及预后因素的评估 ,早期采取恰当的治疗手段可明显改善预后。

Objective: Our purpose was to study the relationship between the prognosis and the characteristics and risk factors of acute coronary artery ischemic syndrome(ACIS). Methods: Questionnaire survey was conducted to 150 patients who were with acute ischemic chest pain and admitted into the hospital.Follow-up study was did on their healty conditions,together with further therapy for 6 months. Then we analyzed the data statisticaly. Results: The average age of the patients was (60.9±9.8), in which 87 were men. One hundred and thirty-four(89.3%) patients were with unstable angina pectoris,and 15(10.0%) with non-Q-wave myocardial infarction(MI). During hospitalization, 68 patients received coronary angiography and 35 received PTCA. Myocardial infarction occurred in 11(7.3%) patients, and heart failure in 8 ( 5.3 %). Five patients died in hospital. Prognosis factors relavated to 7-day mortality included MI history and reinfarction. Prognosis factors related to 6-month mortality included apoB(>1.10 g/L), age(>65), MI history, and reinfarction. Conclusion: The prognosis of ACIS syndrome can be assessed by patients′ basic characteristics and risk factors. With proper therapy, the prognosis can be obviously improved.