新疆石河子846例住院心肌梗死患者的临床特征分析

Clinical features of 846 inpatients with myocardial infarction in Shihezi of Xinjiang

目的比较ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)和非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)患者的一般临床资料、诊治情况、冠状动脉病变特点及近期预后情况。方法回顾性分析新疆石河子大学医学院第一附属医院2002年至2012年收住的846例心肌梗死患者的住院病历资料,对两组患者的临床特征进行统计分析。结果(1)STEMI组与NSTEMI组在年龄、吸烟、家族史上比较,差异无统计学意义(.P>0.05)。(2)两组典型心绞痛症状比较,差异无统计学意义(P>0.05)。(3)NSTEMI组合并原发性高血压(高血压)、高脂血症、心房颤动、心肌梗死率高于STEMI组,差异有统计学意义(P<0.05)。(4)STEMI组及NSTEMI组双联抗血小板、抗凝药的使用率比较,差异无统计学意义(P>0.05)。(5)STEMI组行血运重建治疗率高于NSTEMI组,差异有统计学意义(P<0.05)。(6)STEMI组并发心源性休克、心脏破裂、心律失常、再发心肌梗死比例均高于NSTEMI组,差异无统计学意义(P>0.05);STEMI组病死率高于NSTEMI组,差异有统计学意义(P<0.05)。结论我院心肌梗死患者多为老年患者,以男性为主。我院SIEMI及NSTEMI患者在双联抗血小板、抗凝治疗上无差异,STEMI患者血运重建率高于NSTEMI患者。我院NSTEMI患者多合并高血压、高血脂、陈旧心肌梗死史、心房颤动病史,预后差。我院STEMI患者住院期间易并发心律失常、心源性休克、心脏破裂及死亡等严重心脑血管事件。

Objectives To compare the general clinical features, risk factors, medical treatment, coronary lesion characteristics and short-term prognosis characteristics of ST-segment elevation myocardial infarction （STEMI） and non ST-segment elevation myocardial infarction （NSTEMI） patients in The First Affiliated Hospital of Shihezi University. Methods Clinical data of 846 inpatients with STEMI or NSTEMI in The First Affiliated Hospital of Shihezi University during 2002 and 2012 were retrospectively analyzed. Results （1）There were no significant differences in age, smoking and family history between the two groups （P〉0.05）. （2）There were no significant differences in typical symptoms of angina pectoris between the two groups （P〉0.05）. （3）Incidences of hypertension, hyperlipidemia, atrial fibrillation and myocardial infarction were significantly higher in NSTEMI group than in STEMI group （P〈0.05）. （4） There were no statistical differences between STEMI group and NSTEMI group in the usage rate of dual antiplatelet and anticoagulant （P〉0.05）. （5）STEMI patients had a higher treatment rate of coronary angiography and revascularization than NSTEMI patients, and the difference had statistical significance （P〈0.05）. （6）Though percentages of arrhythmia, cardiogenic shock, cardiac rupture and recurrent myocardial infarction were higher in STEMI group than in NSTEMI group, the differences had no statistical significance（P〉0.05） ; while mortality rate of STEMI group was significantly higher than that of NSTMI group （P〈0.05）. Conclusions In our hospital, the age of patients with myocardial infarction are older and most of them are male. There are no statistical differences between STEMI patients and NSTEMI patientsin usage rate of dual antiplatelet and anticoagulant. STEMI patients have a higher treatment rate of coronary angiography and revascularization than NSTEMI patients. Most NSTEMI patients have high incidences of hypertension, hyperlipidemia, atrial fibrillation and myocardial infarction history, as well as poor prognosis. In our hospital, STEMI patients have high incidences of serious cardiovascular events such as arrhythmia, cardiogenic shock, cardiac rupture and mortality.