心肌梗死再发危险因素的病例对照研究

A CASE CONTROL STUDY ON RELATED RISK FACTORS WITH RECURRENT ACUTE MYOCARDIAL INFARCTION

目的探讨心肌梗死再发的危险因素。方法 2008年7月1日—2013年12月31日,将某集团有限公司在岗和离、退休职工初发心肌梗死的患者纳入观察队列,以初发心肌梗死住院为随访起点,进行追踪随访,每年随访一次,随访其是否再发心肌梗死,并收集临床资料进行比较分析,包括血压、心率、生化指标、疾病的诊断和治疗情况等。以患者再发心肌梗死住院为随访终点。将初发心肌梗死的职工在随访期间再发心肌梗死者作为病例组,无再发者为对照组,对影响心肌梗死再发的因素进行分析。结果 1观察队列中初发心肌梗死者有1 008例,其中有135例再次发生心肌梗死,在135例患者中,符合入选标准为113例。根据纳入排除标准,按照1:2选择对照组226例,由339例观察对象组成观察队列。病例组年龄(62.2±11.5)岁,对照组年龄(62.5±11.7)岁。病例组中男86例(76.1%),对照组中男172例(76.1%)。2分析结果:吸烟史、高血压病史、糖尿病史、高脂血症病史、冠心病家族史、Ⅲ度房室传导阻滞、服用抗血小板药物与心肌梗死再发有关,差异有统计学意义(P<0.05)。结论吸烟、高血压、糖尿病、高血脂症、冠心病家族史、Ⅲ度房室传导阻滞、以及是否服用抗血小板药物是心肌梗死再发的危险因素。

Objective To explore the risk factors of recurrent acute myocardial infarction.Methods From July 1,2008 to December 31,2013,the patients of a group in the post and away,retirees onset myocardial infarction were included in the observational cohort,with the early myocardial infarction in hospital for the follow-up start point.The patients were followed up once a year to observe whether recurrent myocardial infarction,the clnical data included blood pressure,heart rate,and biochemical indicators,diagnosis and treatment of disease.Recurrent myocardial infarction was as the end of the follow-up,the workers of recurrent myocardial infarction were considered as the case group,no recurrent myocardial infarction were as the control group,then the factors affecting recurrent myocardial infarction were analyzed.Results There were 1008 cases of early myocardial infarction in the observational cohort,of which135 cases from happening again.During the 135 patients,113 cases met the inclusion criteria.According to the inclusion and exclusion criteria,226 cases were selected as the control group based on 1∶2.The age of the patient group was 62.2±11.5 years,and the conrol group was 62.5±11.7 years.There were 86 cases men in patient group（76.1%）,172 cases male of in the control group（76.1%）.The results showed that smoking,hypertension,diabetes mellitus,hyperlipidemia medical history,family history of CAD,Ⅲdegree atrioventricular block and taking the antiplatelet drugs influnced the recurrent myocardial infarction,and the differences were statistically significant（P〈0.05）.Conclusions Smoking,hypertension,diabetes,hyperlipidemia,family history of CAD,Ⅲ degree atrioventricular block and whether taking the anti-platelet drugs are the risk factors for recurrence of myocardial infarction.