急性心肌梗死患者介入术后2年预后情况及影响因素分析

Two-year prognosis of patients with acute myocardial infarction after interventional operation and its influencing factors

目的分析急性心肌梗死(AMI)患者介入术后2年预后情况及影响因素。方法选取2016年1月至2019年1月武警陕西总队医院心内科收治的1200例AMI患者为调查对象,医护团队调查AMI介入术后2年再发心肌梗死概率,单因素和多因素Logistic回归分析AMI患者介入术后2年预后影响因素。结果术后2年随访结果显示,共有效随访1188例患者,其中458例出现再发心肌梗死,占38.55%(458/1188);复发组患者中,年龄>70岁、高血压病史、TG异常、LDLC异常、AMI后发生心绞痛、Killip分级≥2级、服药依从性差、冠脉病变为靶血管病变占比明显高于未复发组,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,高龄、有高血压史、AMI后发生心绞痛、术后服药依从性差以及Killip分级≥2级、冠脉病变为靶血管病变是AMI介入术后2年不良预后的影响因素(P<0.05)。结论AMI患者介入术后2年再发心肌梗死风险较高,尤其是年龄高于70岁、有高血压史、AMI后发生心绞痛、术后服药依从性差及Killip分级≥2级和冠脉病变为靶血管病变AMI患者预后更差。

Objective To analyze the 2-year prognosis of patients with acute myocardial infarction(AMI)after interventional operation and its influencing factors.Methods A total of 1200 patients with AMI admitted to the Department of Cardiology,Shaanxi Armed Police Corps Hospital between January 2016 and January 2019 were investigated to calculate the probability of recurrent myocardial infarction in 2 years after interventional operation for AMI.Univariate analysis and multivariate logistic regression analysis were performed to screen the influencing factors of 2-year prognosis.Results Postoperative 2-year follow-up showed that a total of 1188 patients completed the follow-up,and 458 patients had recurrent myocardial infarction,accounting for 38.55%(458/1188).The proportions of patients>70 years old,patients with hypertension history,TG abnormalities,LDLC abnormalities,angina pectoris after AMI,Killip grade≥2,poor medication compliance,and target vascular lesions in the recurrence group were significantly higher than those in the non-recurrence group(P<0.05).Logistic regression analysis indicated that advanced age,hypertension history,angina pectoris after AMI,postoperative poor medication compliance,Killip grade≥2,and target vascular lesions were influencing factors of poor prognosis of patients with AMI in 2 years after interventional operation(P<0.05).Conclusion The risk of recurrent myocardial infarction is relatively high in patients with AMI in 2 years after interventional operation.Patients>70 years old,patients with hypertension history,angina pectoris after AMI,poor medication compliance after operation,Killip grade≥2,and target vascular lesions have worse prognosis.