急性心肌梗死后室壁瘤形成的多因素分析

发布时间：2018-05-02 06:23

  本文选题：急性心肌梗死 + 室壁瘤　； 参考：《遵义医学院》2017年硕士论文

【摘要】：目的:通过对急性心肌梗死(Acute myocardial infarction,AMI)合并室壁瘤(Ventricular aneurysm,VA)病史资料、并发症、冠状动脉病变情况、实验室指标、心脏彩超指标、预后进行回顾性分析,探讨AMI合并VA的临床特征和危险因素,寻找VA发生的可控危险因素,并提出干预措施,为降低临床VA发生率和相应心血管事件提供资料和证据。方法:回顾性收集分析遵义医学院心内科2010年1月-2016年9月住院期间确诊AMI合并VA的患者70例纳入研究组,并随机选取同期不合并VA的AMI患者70例作为对照。通过对2组患者病史资料、并发症、冠状动脉病变情况、实验室指标、心脏彩超指标、预后做统计分析,建立AMI合并VA的Logistic回归模型,寻找VA发生的可控危险因素。结果:(1)在单因素分析中,年龄(68.01±11.081 vs 56.93±10.772,P=0.000)、吸烟史(45.71%vs 68.57%,P=0.006)、既往心肌梗死病史(42.85%vs 8.57%,P=0.000)、既往脑卒中病史(32.28%vs 0.00%,P=0.000)、全心衰(14.28%vs0.00%,P=0.001)、单纯左心衰(30.00%vs 8.57%,P=0.001)、左心室射血分数(Left Ventricular Ejection Fraction,LVEF)值降低(90.00%vs 45.55%,P=0.000)、合并脑卒中(30.00 vs 4.28%,P=0.000)、院外1年内全因死亡率(10.00%vs 14.28%,P=0.000)、前降支血管病变(95.74%%vs 80.00%,P=0.016)、APOB(0.8380±0.30044 vs 1.0127±.23991,P=0.000)、白细胞升高(28.57 vs 45.71%,P=0.000)在VA和无VA两组之间均有显著不同。(2)经多因素分析,年龄(OR=1.072b=0.069 P=0.005 95%CI=1.021-1.125)、既往有心肌梗死病史(OR=8.228b=2.108 P=0.002 95%CI=2.120-31.931)、LVEF值降低(OR=6.905b=1.932 P=0.006 95%CI=1.747-27.294)、合并脑卒中(OR=5.483b=1.702 P=0.030 95%CI=1.180-25.474)为VA形成的独立危险因素。结论:年龄、既往心肌梗死病史、LVEF值降低和合并脑卒中为VA形成的独立危险因素。临床上积极干预上述危险因素,降低临床AMI后VA发生率,改善预后。
[Abstract]:Objective: to analyze retrospectively the history, complications, coronary artery disease, laboratory indexes, cardiac color Doppler ultrasonography and prognosis of acute myocardial infarction (AMI) with ventricular aneurysm. To explore the clinical characteristics and risk factors of AMI combined with VA, to find out the controllable risk factors of VA, and to provide data and evidence for reducing the incidence of clinical VA and corresponding cardiovascular events. Methods: a retrospective study was conducted on 70 patients with AMI combined with VA from January 2010 to September 2016 in Department of Cardiology, Zunyi Medical College, and 70 AMI patients without VA were randomly selected as control group. Based on the statistical analysis of history, complications, coronary artery disease, laboratory indexes, cardiac color Doppler imaging and prognosis, the Logistic regression model of AMI combined with VA was established to find out the controllable risk factors of VA. Results in univariate analysis, 骞撮緞(68.01卤11.081 vs 56.93卤10.772,P=0.000),鍚哥儫鍙，

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