老年急性心肌梗死伴心力衰竭患者心血管不良事件发生的影响因素分析与对策

Analysis of influencing factors and strategies for cardiovascular adverse events in elderly patients with acute myocardial infarction and heart failure

目的探讨老年急性心肌梗死伴心力衰竭患者心血管不良事件发生的影响因素及干预对策。方法回顾分析2016年12月至2017年12月在我院心内科接受治疗的老年心肌梗死合并心力衰竭患者138例作为研究对象,根据是否发生心血管不良事件分为对照组83例(未发生心血管不良事件)与观察组55例(发生心血管不良事件)。两组入院后查阅病例资料,记录并统计两组患者性别、年龄、高血压、糖尿病、高脂血症、吸烟、CK、Hb、UA、BNP、SBP、DBP、Scr、TC、TG及LDL-C水平,对上述影响因素进行单因素及多因素logistic分析;针对心血管不良事件发生影响因素提出相应的干预对策。结果单因素结果表明,老年心肌梗死合并心力衰竭患者心血管不良事件发生因素与性别、糖尿病、吸烟、TC、TG、LDL-C水平无关,差异无统计学意义(P>0.05);老年心肌梗死合并心力衰竭患者心血管事件发生因素与年龄、高血压、高脂血症、CK、Hb、UA、BNP、SBP、DBP、Scr水平有关,差异具有统计学意义(P<0.05);多因素logistic分析结果表明,老年心肌梗死合并心力衰竭患者心血管事件发生因素与年龄、高血压、高血脂症、CK、Hb、UA、BNP及Scr水平有关。结论老年急性心肌梗死伴心力衰竭患者心血管患者不良事件发生率较高且影响因素较多,应根据危险因素制定有效的措施进行干预,降低其心血管不良事件发生率。

Objective To investigate the influencing factors and intervention strategies for cardiovascular adverse events in elderly patients with acute myocardial infarction and heart failure. Methods To analyzed the influencing factors by univariate and multivariate logistic analysis,and to developed corresponding intervention strategy concerning the influencing factors of cardiovascular adverse events,138 cases of elderly patients with acute myocardial infarction and heart failure treated in our hospital from December 2016 to December 2017 were observed. 83 cases of patients were sampled as control group（ without cardiovascular adverse events） and 52 cases of patients were sampled as study group（ with cardiovascular adverse event） based on the standard of with or without cardiovascular adverse event occurrence. Patients＇ records were reviewed after admission to the hospital,particularly the gender,age,status of hypertension,diabetes,hyperlipidaemia,smoking,CK,Hb,UA,BNP,SBP,DBP,Scr,TC,TG and LDL-C. Results Univariate results showed that the incidence of cardiovascular adverse events in elderly patients with myocardial infarction complicated with heart failure was not related to gender,diabetes,smoking,TC,TG,LDL-C levels,and the difference was not statistically significant（ P〈0. 05）. The cardiovascular events in elderly patients with myocardial infarction complicated with heart failure were related to age,hypertension,hyperlipidemia,CK,Hb,UA,BNP,SBP,DBP and Scr levels,and the difference was statistically significant（ P〈0. 05）. Multivariate logistic analysis showed that cardiovascular events in elderly patients with myocardial infarction complicated with heart failure were related to age,hypertension,hyperlipidemia,CK,Hb,UA,BNP and Scr levels. Conclusion The incidence of adverse events in elderly patients with acute myocardial infarction and heart failure were relatively high and multiply affected,effective intervention should be made according to the risk factors to reduce the incidence of cardiovascular adverse events.