急性心肌梗死首发心力衰竭患者的预后及病死率分析

Prognosis and Mortality Analysis of Patients with Acute Myocardial Infarction Complicated with First Heart Failure

目的:分析急性心肌梗死首发心力衰竭患者死亡原因、预后效果的影响因素。方法:选取2018年12月-2020年12月甘肃省镇原县第一人民医院治疗的急性心肌梗死患者186例为研究对象,其中并发心力衰竭78例为观察组,未并发心力衰竭108例为对照组,比较两组患者临床资料、病死率,并分析诱发病死因素。结果:观察组病死率高于对照组,差异有统计学意义(P<0.05);观察组冠状动脉造影手术、冠状动脉再灌注治疗及发生血管硬化低于对照组,观察组β受体阻滞剂药物治疗、他汀类药物治疗例数高于对照组,差异有统计学意义(P<0.05)。结论:在急性心肌梗死首发心力衰竭患者的临床治疗中,需立即为患者建立静脉通道,并进行冠状动脉再灌注治疗,这样能够有效缩小心肌坏死范围,提升心肌细胞的存活率,从而起到保护患者心肌功能的作用,降低病死率,改善预后,对患者生命安全及生活质量有积极意义。

Objective:To analyze the causes of mortality and the influencing factors of prognostic effect of patients with acute myocardial infarction complicated with heart failure for the first time.Methods:From December 2018 to December 2020,186 patients with acute myocardial infarction complicated with heart failure for the first time who were treated in the First People's Hospital of Zhenyuan County were selected as the study subjects,including 78 cases complicated with heart failure as observation group,and 108 cases complicated with no heart failure as control group.The clinical data and mortality of patients in two groups were compared,and the factors inducing the mortality were analyzed.Results:The mortality rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The number of case receiving the coronary angiography,coronary reperfusion therapy and with vascular sclerosis in the observation group was lower than that in the control group.The number of cases receivingβreceptor blocker drug treatment and statin drug treatment was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:In the clinical treatment of patients with acute myocardial infarction complicated with heart failure for the first time,it is necessary to immediately establish venous channel,and perform coronary artery reperfusion therapy,which can effectively reduce myocardial necrosis range,increase the survival rate of myocardial cells,thus protecting myocardial function in patients,reducing the mortality,improving the prognosis,and having positive significance on the life safety and quality of life of patients.