冠心病患者再入院的危险因素分析

Analysis of risk factors in readmission patients with coronary heart disease

目的探讨造成冠心病患者再入院的危险因素,以加强高危人群的干预措施,降低冠心病患者的反复入院率。方法入选因冠心病二次入院的患者115例为研究组,并入选同期一次入院的冠心病患者78例为对照组,对其临床资料进行回顾性分析,探讨冠心病患者再次住院相关的危险因素。结果研究组年龄、合并高血压(HBP)或2型糖尿病(T2DM)率、首次以急性心肌梗死(AMI)入院率、纽约心脏病协会心功能分级(NYHA)、心脏超声左心房内径(LAD)、左心室舒张末内经(LVEDD)、室间隔厚度(IVS)、左心室后壁(LVPW),均显著高于对照组(P<0.05),左心室射血分数(LVEF)显著小于对照组(P<0.05)。多因素logistic回归分析显示高龄、合并高血压、LAD增大、EF降低是冠心病再入院的相关危险因素(P<0.05)。结论对高龄、合并高血压及血糖异常、NYHA分级或心脏超声提示心功能较差及急性心肌梗死入院患者应积极控制相关危险因素,积极采取措施改善心功能,对于降低冠心病患者的再入院率具有积极意义。

Objective To analyze the risk factors in readmitted patients with coronary heart disease,intending to strength the preventive and therapeutic strategy to reduce the readmission ratio of high-risk population.Methods A total of 115 readmitted patients with CHD were selected as the experiment group,on the contrary,78 initial patients with CHD were statistically analyzed as the control group.The relationship between readmission and clinical indicators were explored.Results The valnes in age,high blood pressure,T2 DM,AMI,cardiac function NYHA Ⅲ-Ⅳ,LAD,LVEDD,IVS and LVPW were significantly higher in experiment group than in control group,however,LVEF was significantly lower in experiment group than in control group（P〈0.05）.Multivariable logistic regression analysis showed that age,hypertension,LAD,and LVEF were associated with readmission（P〈0.05）.ConclusionStrengthening the intervention and devoting special attention on patients with high blood pressure and diabetes,elderly ages and the related complications,taking measures to improve heart function will have substantial benefits on preventing the readmission in patients with CHD.