合并高血压的急性ST段抬高型心肌梗死患者的临床特征及住院死因分析

发布时间：2019-04-18 20:46

【摘要】：目的探讨急性ST段抬高型心肌梗死(STEMI)合并或不合并高血压患者的临床特征及住院死亡原因。方法入选2007年1月至2010年1月期间入住安徽医科大学第一附属医院心内科的STEMI患者317例,分为有高血压史STEMI组(高血压组,n=166)和无高血压史STEMI组(非高血压组,n=151)。探讨合并高血压的STEMI患者的临床特征及住院死亡可能原因。结果高血压组平均年龄高于非高血压组[(66.3±11.5)比(60.9±14.9)岁,P0.05]。高血压组心力衰竭和住院死亡发生率高于非高血压组[30.1%比17.1%;12.7%比3.3%;均P0.05]。多元逐步Logistic回归分析发现入院时心率、心源性休克及节段性运动异常为STEMI患者住院死亡的重要危险因素(均P0.05)。入院时收缩压及合并心房颤动是STEMI合并高血压患者住院死亡的重要预测因子(均P0.05)。结论合并高血压的STEMI患者年龄较大,心力衰竭和住院死亡发生率较高。入院时心率、心源性休克及节段性运动异常可能为STEMI患者住院死亡的重要危险因素。
[Abstract]:Objective to investigate the clinical features and causes of death in patients with acute ST segment elevation myocardial infarction (STEMI) with or without hypertension. Methods A total of 317 STEMI patients admitted to the Department of Cardiology of the first affiliated Hospital of Anhui Medical University from January 2007 to January 2010 were divided into two groups: STEMI group (hypertension group) and STEMI group (non-hypertension group). To investigate the clinical features of STEMI patients with hypertension and the possible causes of death in hospital. Results the mean age of hypertension group was higher than that of non-hypertension group [(66.3 卤11.5) vs (60.9 卤14.9) years, P0.05]. The incidence of heart failure and hospital death in hypertension group was higher than that in non-hypertension group [30.1% vs 17.1% vs 12.7% vs 3.3%; P0.05]. Multiple stepwise Logistic regression analysis showed that heart rate cardiogenic shock and segmental dyskinesia were significant risk factors for death in STEMI patients (P0.05). Systolic blood pressure (SBP) and atrial fibrillation (AF) at admission were important predictors of death in STEMI patients with hypertension (P 0.05). Conclusion STEMI patients with hypertension are older and have higher incidence of heart failure and in-hospital death. Heart rate, cardiogenic shock and segmental motion abnormality at admission may be important risk factors for death in patients with STEMI.
【作者单位】：安徽医科大学第一附属医院心血管内科;安徽医科大学第一附属医院妇产科门诊;
【基金】：2014年度安徽高校省级自然科学研究重点项目(KJ2014A125)
【分类号】：R542.22;R544.1

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