体质量指数与急性ST段抬高型心肌梗死患者预后的相关性研究

Correlation between body mass index and prognosis in patients with ST-segment elevation myocardial infarction

目的探讨体质量指数(BMI)对急性ST段抬高型心肌梗死(STEMI)患者预后的影响。方法回顾性收集该院2014年收治的STEMI住院患者的临床资料,将患者根据BMI分为4组:低体质量组(n=31)、正常体质量组(n=139)、超重组(n=71)和肥胖组(n=26),对比分析4组患者的临床基线资料,并随访心肌梗死后7d和年内的全因死亡率。结果 BMI越高患者发病年龄越轻(P<0.01),女性所占比例越小(P=0.001),其中肥胖组患者的清蛋白水平、血红蛋白水平均相对较高(P=0.004;P=0.006);心肌梗死后1年的全因死亡率随着BMI升高而明显降低(P=0.003),心肌梗死后7d的全因死亡率差异无统计学意义(P=0.287)。结论 BMI与STEMI患者的远期预后相关,"肥胖矛盾"现象在STEMI患者中是存在的,但应结合患者年龄、性别、并发症和药物治疗等多个因素综合评估BMI对STEMI患者预后的影响。

Objective To investigate the impact of body mass index （BMI） on short-term and long-term prognosis in the patients with ST-segment elevation myocardial infarction （STEMI）. Methods The clinical data of inpatients with STEMI in our hospital during 2014 were retrospectively collected. The patients conforming to the inclusion and exclusion criteria were divided into 4 groups according to BMI, low BMI group （n = 31）, normal BMI group （n = 139）, overweight group （n = 71 ） and obesity group （n = 26）. The clinical baseline data were analyzed and compared among 4 groups,and the all-cause mortality on 7 d and within 1 year after myocardial infarction（MI） was followed up. Results The higher the BMI increased,the younger the patient＇s onset age （P〈 0.01 ）, the smaller the female proportion（P= 0. 001）, among them, the albumin and hemoglobin levels in the obesity group were relatively higher（P= 0. 004;P=0. 006） ;the all-cause mortality at 1 year after MI was significantly decreased with BMI increasing （P =0. 003） ,while which on 7 d after MI had no statistical difference （P=0. 287）. Conclusion BMI is correlated with the long-term prognosis in the patients with STEMI,and ＂obesity contradiction＂ phenomenon exists in the patients with STEMI. However, the influence of BMI on the prognosis in the patients with STEMI should be comprehensively evaluated by combining with the multiple factors such as the patientt s age,sex, complications and medication therapy.