急性心肌梗死并发心脏破裂危险因素的病例对照研究

发布时间：2018-06-18 23:36

本文选题：心脏破裂 + 危险因素　；参考：《中国循环杂志》2016年05期

【摘要】：目的:分析急性心肌梗死并发心脏破裂的临床特点、危险因素,并探究临床防治措施。方法:收集泰达国际心血管病医院收治的有冠状动脉造影资料的急性心肌梗死并发心脏破裂患者44例,为心脏破裂组。在同期急性ST段抬高型心肌梗死(STEAMI)患者中,按1:3匹配原则选择对照组132例。统计两组患者临床资料,采用Logistic回归方法分析具有心脏破裂预测价值的相关危险因素。结果:心脏破裂组β受体阻滞剂使用率明显低于对照组(22.7%vs 84.1%),差异有统计学意义(P0.05)。单因素Logistic回归分析表明低体重指数、初发心肌梗死、前壁心肌梗死、未行再灌注治疗、再灌注时间延迟、就诊时低血压、心肌梗死后反复胸痛、室壁瘤、高Gensini评分、高水平血肌酐、高B型利钠肽、低射血分数是心脏破裂的危险因素(P均0.05)。多因素Logistic回归分析表明初发心肌梗死(P0.049,比值比=7.462)、心肌梗死后反复胸痛(P0.000,比值比=8.591)、室壁瘤(P0.005,比值比=4.617)、高Gensini评分(P0.001,比值比=2.788)是心脏破裂的危险因素。结论:初发心肌梗死、心肌梗死后反复胸痛、室壁瘤、高Gensini评分是STEAMI患者心脏破裂的危险因素。
[Abstract]:Objective: to analyze the clinical characteristics and risk factors of acute myocardial infarction complicated with cardiac rupture, and to explore the clinical prevention and treatment measures. Methods: 44 patients with acute myocardial infarction complicated with cardiac rupture were collected from Teda International Cardiovascular Hospital. In the same period, 132 patients with acute St segment elevation myocardial infarction were selected as control group according to 1:3 matching principle. The clinical data of the two groups were analyzed and logistic regression was used to analyze the risk factors of cardiac rupture. Results: the utilization rate of 尾 -blocker in cardiac rupture group was significantly lower than that in control group (22.7 vs 84.1), and the difference was statistically significant (P 0.05). Univariate logistic regression analysis showed low body mass index, primary myocardial infarction, anterior wall myocardial infarction, no reperfusion therapy, delayed reperfusion time, hypotension, recurrent chest pain after myocardial infarction, ventricular aneurysm, high Gensini score. High levels of serum creatinine, high type B natriuretic peptide and low ejection fraction were the risk factors of heart rupture (P < 0.05). Multivariate logistic regression analysis showed that P 0.049, P 0.000, P 0.000, P 0.005, P 0.005, P 0.001 and P 0.001, P 0.001, P 0.001, P 0.001 and 2.788 were risk factors of cardiac rupture. Conclusion: recurrent chest pain, ventricular aneurysm and high Gensini score are risk factors of heart rupture in patients with STEAMI.
【作者单位】：天津医科大学心血管病临床学院;泰达国际心血管病医院;
【基金】：滨海新区卫生局科技项目(2014BWK2001)
【分类号】：R542.22

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