急性心肌梗死的危险因素分析

Analysis in risk factors of acute myocardial infarction

目的分析急性心肌梗死的危险因素,以促进急性心肌梗死的有效防治。方法将326例冠心病患者分为急性心肌梗死组156例和慢性稳定型劳力性心绞痛组170例。收集2组患者的一般资料,包括性别、年龄、高血压病史、糖尿病病史、吸烟史、饮酒史以及入院后次日清晨空腹血清同型半胱氨酸、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、肌酐、尿素氮、空腹血糖、白细胞计数、中性粒细胞百分比、超敏C反应蛋白水平。结果2组性别、吸烟史、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、同型半胱氨酸、超敏C反应蛋白、白细胞计数、中性粒细胞百分比有显著差异(P<0.05)。Logistic回归分析结果显示,同型半胱氨酸、低密度脂蛋白胆固醇、吸烟史、超敏C反应蛋白、白细胞计数、中性粒细胞百分比是急性心肌梗死的危险因素(P<0.05)。2组血脂正常患者同型半胱氨酸水平、超敏C反应蛋白水平、白细胞计数水平、中性粒细胞百分比、吸烟史比较,差异有统计学意义(P<0.05)。结论同型半胱氨酸、低密度脂蛋白胆固醇、吸烟史、超敏C反应蛋白、白细胞计数、中性粒细胞百分比是急性心肌梗死的危险因素,早期针对高同型半胱氨酸血症进行干预,可降低急性心肌梗死患者的病死率。

Objective To analyze the risk factors of acute myocardial infarction so as to effectively prevent acute myocardial infarction.Methods Totally 326 patients with coronary heart disease were divided into acute myocardial infarction group(n=156)and chronic stable exertional angina pectoris group(n=170).The general materials such as gender,age,history of hypertension,history of diabetes,history of smoking,history of drinking as well as levels of fasting homocysteine,triglyceride,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,creatinine,urea nitrogen,fasting blood glucose,white blood cell count,neutrophil percentage and high-sensitivity C reactive protein in the morning of the next day after admission were collected in both groups.Results There were significant differences in gender,history of smoking,triglycerides level,total cholesterol level,low-density lipoprotein cholesterol level,homocysteine level,high-sensitivity C reactive protein level,white blood cell count and neutrophil percentage between the two groups(P<0.05).Logistic regression analysis showed that homocysteine,low-density lipoprotein cholesterol,history of smoking,high-sensitivity C reactive protein,white blood cell count and neutrophil percentage were risk factors of acute myocardial infarction(P<0.05).There were significant differences in homocysteine level,high-sensitivity C-reactive protein level,white blood cell count,neutrophil percentage and history of smoking in patients with normal blood lipid level between the two groups(P<0.05).Conclusion Homocysteine,low-density lipoprotein cholesterol,history of smoking,high-sensitivity C reactive protein,white blood cell count and neutrophil percentage are risk factors of acute myocardial infarction.Early intervention for hyperhomocysteinemia can reduce the mortality of patients with acute myocardial infarction.