主动脉夹层患者院内死亡危险因素分析

发布时间：2018-03-31 23:21

本文选题：医院死亡率　切入点：主动脉夹层　出处：《中国全科医学》2017年30期

【摘要】：目的探讨主动脉夹层(AD)患者院内死亡的危险因素,为临床制定有效的治疗方案提供参考。方法收集2010年1月—2012年1月新疆医科大学第一附属医院心脏重症监护室收治的符合纳入标准的224例AD患者的临床资料,根据患者住院期间是否死亡分为存活组(201例)和死亡组(23例)。回顾性分析患者的临床资料(包括一般情况、基础体征、临床指标),并分析其院内死亡的危险因素。结果两组患者饮酒史、高血压史、发病时间、De Bakey分型、入院后手术情况比较,差异有统计学意义(P0.05)。死亡组患者舒张压、红细胞计数、红细胞比容、嗜酸粒细胞百分比、嗜碱粒细胞百分比、嗜酸粒细胞计数、嗜碱粒细胞计数、血红蛋白、血小板计数、血小板压积、总蛋白、球蛋白、凝血酶原时间活动度、纤维蛋白原低于存活组,空腹血糖、载脂蛋白AI高于存活组,凝血酶原时间长于存活组,国际标准化比率、主动脉窦部直径大于存活组(P0.05)。以患者院内死亡情况为因变量,将上述单因素分析筛选出来的P0.01的变量为自变量进行多因素Logistic回归分析,得到回归方程:Y=0.555-8.124×嗜碱粒细胞计数-0.036×血红蛋白+0.104×主动脉窦部直径。结论嗜碱粒细胞计数、血红蛋白是AD患者院内死亡的保护因素,主动脉窦部直径是独立危险因素。提示临床可加强对AD住院患者上述指标的监测。
[Abstract]:Objective to investigate the risk factors of hospital death in patients with aortic dissection. Methods from January 2010 to January 2012, the clinical data of 224 AD patients admitted to the cardiac intensive care unit of the first affiliated Hospital of Xinjiang Medical University were collected. The patients were divided into survival group (201 cases) and death group (23 cases) according to whether they died in hospital. Results the history of alcohol consumption, history of hypertension, time of onset and de Bakey classification, and operation after admission were significantly different between the two groups. The diastolic blood pressure (DBP) and red blood cell count (RBC) of the patients in the dead group were significantly higher than those in the control group (P < 0.05). Erythrocyte volume, percentage of eosinophil, percentage of eosinophil, eosinophil count, eosinophil count, hemoglobin, platelet count, platelet hematocrit, total protein, globulin, prothrombin time activity, Fibrinogen was lower than survival group, fasting blood glucose and apolipoprotein AI were higher than those in survival group, prothrombin time was longer than that in survival group, international standardized ratio, diameter of aortic sinus was larger than survival group (P0.05). The variables of P0.01 selected by univariate analysis were analyzed by multivariate Logistic regression analysis, and the regression equation was obtained: the eosinophil count was 0.555-8.124 脳 -0.036 脳 hemoglobin 0.104 脳 diameter of aortic sinus. Hemoglobin is the protective factor of hospital death in AD patients, and the diameter of aortic sinus is an independent risk factor.
【作者单位】：浙江省杭州市余杭区第一人民医院心内科;新疆医科大学第一附属医院冠心病二科;
【基金】：新疆维吾尔自治区杰出青年科技人才培养项目(2014711003)
【分类号】：R543.1

【相似文献】