未接受血运重建治疗的高龄急性非ST段抬高型心肌梗死患者临床预后

发布时间：2018-05-06 21:47

本文选题：急性非ST段抬高型心肌梗死 + 高龄　；参考：《实用医学杂志》2016年21期

【摘要】：目的:分析未接受血运重建治疗的高龄急性非ST段抬高型心肌梗死(NSTEMI)患者预后情况,并对相关危险因素进行分析。方法:对2014年1月1日至2015年1月1日因NSTEMI入住我院急诊科病房未接受血运重建治疗(冠脉介入治疗或者冠脉搭桥治疗)的高龄患者(年龄≥75岁)进行随访,并对可能影响患者预后的临床资料进行分析。结果:研究共纳入患者61例,完成随访患者53例,1年随访期间发生主要心血管事件(MACE)患者37例,同无事件组患者相比较,发生事件组患者年龄较大、入院期间肌钙蛋白峰值、pro BNP以及D-Dimer水平较高,低密度脂蛋白胆固醇(LDL-C)水平较低,同时GRACE评分和CHADS2评分分值高。进一步的Logistic回归分析提示高龄、GRACE评分和CHADS2评分高以及LDL-C水平低是发生MACE的独立危险因素。结论:未接受再血管化治疗的高龄NSTEMI患者发生MACE的风险高,尤其是对于高龄、GRACE和CHADS2评分高和LDL-C水平低的患者。
[Abstract]:Objective: to analyze the prognosis of elderly patients with acute non ST segment elevation myocardial infarction (NSTEMI) without revascularization, and to analyze the related risk factors. Methods: unaccepted blood reconstructive treatment (coronary intervention therapy or coronary artery bypass treatment) for the emergency department ward of our hospital from January 1, 2014 to January 1, 2015. The elderly patients (age more than 75 years old) were followed up and analyzed the clinical data that might affect the prognosis of the patients. Results: the study included 61 cases, 53 cases of follow-up patients and 37 cases of major cardiovascular events (MACE) during the 1 year follow-up. Compared with those in the non event group, the patients in the event group were older and were hospitalized. The peaks of troponin, pro BNP and D-Dimer were higher, low density lipoprotein cholesterol (LDL-C) was lower, and GRACE score and CHADS2 score were higher. Further Logistic regression analysis suggested that the higher age, the higher GRACE score, the CHADS2 score and the low LDL-C level were independent risk factors for MACE. Conclusion: no revascularization was accepted. The risk of MACE is high in elderly NSTEMI patients, especially for elderly patients with high GRACE and CHADS2 scores and low LDL-C levels.

【作者单位】：首都医科大学附属北京世纪坛医院急诊科;首都医科大学附属北京世纪坛医院神经内科;
【分类号】：R542.22

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