急性心肌梗死并急性脑梗死75例临床救治分析

Clinical Analysis of 75 cases of Acute Myocardial Infarction complicated with Acute Cerebral Infarction

目的探讨急性心肌梗死(AMI)患者合并发急性脑梗死(AIS)的发生率及其危险因素,从而更好的预防急性心肌梗死并发急性脑梗死。方法回顾性分析我院收治的8628例急性心肌梗死出现急性脑梗塞患者共75例,采用多因素Logistic回归分析AMI合并AIS的危险因素;以及单纯AMI组与单纯AIS组临床相关指标变化。结果 AMI合并AIS组与单纯AMI组及单纯AIS组比较,患者年龄、吸烟、心房颤动、空腹血糖受损、糖耐量受损、糖尿病、收缩压、高密度脂蛋白胆固醇(HDL-C)差异有统计学意义(P <0.05)。多因素Logistic回归分析显示,性别、入院舒张压、既往脑梗死病史、血肌酐水平为心肌梗死合并急性脑梗死的独立危险因素(P <0.05)。结论高龄急性心肌梗死合并急性脑梗死患者较多,预后差,院前加强危险因素的控制措施,住院后采取积极预防,减少危险因素等综合治疗措施可显著改善预后。

Objective To investigate the incidence and risk factors of acute cerebral infarction(AIS)in patients with acute myocardial infarction(AMI).Methods 8628 patients with acute myocardial infarction admitted in our hospital from January 2008 to January 2018 were analyzed retrospectively.The risk factors of AMI combined with AIS were analyzed by multivariate Logistic regression analysis,as well as the changes of clinical related indexes between AMI group and AIS group.Results Age,smoking,atrial fibrillation,impaired fasting blood glucose,impaired glucose tolerance,diabetes,systolic blood pressure,and high density lipoprotein cholesterol(HDL-C)in AMI combined with AIS group were significantly higher than those in AMI group and AIS group(P<0.05).Conclusions Elderly patients with acute myocardial infarction(AMI)complicated with acute cerebral infarction(ACI)had a poor prognosis.Strengthening the control measures of risk factors before hospitalization and taking active treatment after hospitalization could significantly improve the prognosis.