老年非ST段抬高型急性心肌梗死患者临床特征及预后影响因素

发布时间：2018-06-29 21:51

  本文选题：心肌梗死 + 非ST段抬高型急性心肌梗死　； 参考：《山东医药》2016年11期

【摘要】：目的探讨老年非ST段抬高型急性心肌梗死(NSTEMI)患者的临床特征及预后影响因素。方法 135例老年急性心肌梗死患者,其中NSTEMI患者72例、ST段抬高型急性心肌梗死(STEMI)患者63例,比较NSTEMI与STEMI患者的临床资料,同时采用Cox回归模型分析影响老年NSTEMI患者预后的相关因素。结果 NSTEMI、STEMI患者中糖尿病分别为30、12例,高血压分别为49、31例,持续性胸痛分别为40、53例,心力衰竭分别为45、27例,肌酸激酶峰值分别为(829.55±125.64)、(2 354.45±351.01)IU/L,肌钙蛋白I峰值分别为(0.86±0.24)、(1.86±0.64)ng/m L,两者比较,P均0.05。出院后1年期间内,NSTEMI患者再发心绞痛发生率、心力衰竭发生率和病死率均高于STEMI患者(24.3%vs.11.7%,18.6%vs.6.7%,25.7%vs.8.3%),P均0.05。高龄(65岁)(HR=2.13)、心力衰竭(HR=3.37)和入院时Killip≥3级(HR=1.79)为老年NSTEMI患者近期预后的危险因素,服用阿司匹林(HR=0.51)为老年NSTEMI患者近期预后的保护因素。结论与老年STEMI患者相比,老年NSTEMI患者合并糖尿病、高血压和心力衰竭更多,持续性胸痛更少,肌酸激酶峰值和肌钙蛋白I峰值更低。老年NSTEMI患者远期预后较差,高龄(65岁)、伴心力衰竭和入院时Killip≥3级老年NSTMEI患者预后风险增加,服用阿司匹林老年NSTMEI患者预后风险降低。
[Abstract]:Objective to investigate the clinical features and prognostic factors of elderly patients with non-St segment elevation acute myocardial infarction (NSTEMI). Methods the clinical data of 135 elderly patients with acute myocardial infarction (AMI), including 72 patients with STEMI and 63 patients with STEMI, were compared between NSTEMI and STEMI. Cox regression model was used to analyze the prognostic factors of elderly patients with NSTEMI. Results there were 12 cases of diabetes mellitus, 31 cases of hypertension, 4053 cases of persistent chest pain, 27 cases of heart failure, (829.55 卤125.64), (2 354.45 卤351.01) ng/m / L of creatine kinase and (0.86 卤0.24), (卤0.86 卤0.64) ng/m / L of cardiac troponin I, respectively. The incidence of recurrent angina pectoris, heart failure and mortality in patients with NSTEMI within one year after discharge were higher than those in patients with STEMI (24.3vs.11.70.18.6vs.6.7%) (P < 0.05). Old age (65 years) (HR2.13), heart failure (HR3.37) and admission Killip 鈮，

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