影响急性心肌梗死患者近期预后因素的分析

Analysis of factors on the recent prognosis in patients with AMI.

目的 探讨影响急性心肌梗死 (AMI)患者近期预后的各相关指标 ,旨在为降低 AMI近期死亡率提供依据。方法 观察分析近 4年来收治的急性心肌梗死 2 83例 ,依据 4周内存亡情况分为两组 ,存活组 2 4 0例 ,男性 174例 ,女性 6 6例 ,死亡组 4 3例 ,男性 2 5例 ,女性 18例 ,对比分析其年龄、既往史 (高血压、糖尿病、高脂血症 )、临床及溶栓治疗、并发症、死亡率。结果 年龄两组无显著性差异。存活组中高血压、糖尿病、高脂血症发生率分别低于死亡组 ;心力衰竭、心源性休克低于死亡组 ,两组间有显著差异。多元素逻辑回归分析显示胸痛、合并糖尿病、前壁心肌梗死、溶栓治疗并不是住院死亡的危险因素 ,而近期预后与年龄、合并高血压、高脂血症、就诊时间、心力衰竭、心源性休克、WBC(白细胞 )增高密切相关。

Objective To investigate the various related prognostic factors with so as to reduce the mortality of early AMI. Methods: 283 patients with AMI were observed and analysed,with 174 males and 66 female in recent 4 years. Results: There was no significant difference of surviving group and death group on age. The incidence of hypertension, diabetes and hyperlipemia in surviving group was lower than that of death group. There were significant difference of two groups on heart failure and chest pain of cardiogenic shock. Diabetes, anterior AMI and thrombolysis therapy were not the risk factors based on the multielement logistic regression, but the prognostic factors were related to age, hypertension, hyperlipemia ,the date of taking medical attention, heart failure,cardiogenic shock and increase of WBC. Conclusion: There are many factors which made influence the mortality of AMI.