海南“候鸟人群”急性心肌梗死发作的特点与预后分析

发布时间：2018-04-09 08:18

本文选题：心肌梗死　切入点：人群监测　出处：《中国循环杂志》2017年11期

【摘要】：目的:探讨海南"候鸟人群"急性心肌梗死(AMI)的发作特点及预后分析。方法:连续入选2012~2015年冬季在我院住院的1 246例冠心病患者,其中发生AMI的255例。患者根据来源分为"候鸟人群"组(n=197)和海南人群组(n=58),比较两组患者的临床资料、危险因素、冠状动脉造影、介入治疗资料及院内转归。结果:两组患者的年龄、高血压、糖尿病、吸烟、血脂水平差异无统计学意义。"候鸟人群"组患者到达海南后发生AMI的平均时间为(3.15±2.67)天。与海南人群组比较,"候鸟人群"组急性ST段抬高型心肌梗死的发病比例高[70.56%(139/197)vs 51.72%(30/58),P=0.003],冠状动脉单支+双支病变的比例高(P=0.009)、血栓抽吸的比例高(P=0.008),而支架置入的数量少(P=0.007);发生AMI后出现心原性休克的比例(12.69%vs 3.45%,P=0.044)和心原性休克+死亡的比例(16.24%vs 3.45%,P=0.022)均较高。结论:"候鸟人群"AMI患者中,急性ST段抬高型心肌梗死发病比例高,简单病变多、血栓抽吸多、预后差。
[Abstract]:Objective: to investigate the attack characteristics and prognosis of AMI in Hainan Migratory Bird population.Methods: 1 246 patients with coronary heart disease were enrolled in our hospital in the winter of 2012 ~ 2015, including 255 cases of AMI.The patients were divided into two groups according to their origin: "Migratory Birds" group and Hainanese population group. The clinical data, risk factors, coronary angiography, interventional treatment data and hospital outcome were compared between the two groups.Results: there was no significant difference in age, hypertension, diabetes, smoking and blood lipid levels between the two groups. "The average time of occurrence of AMI after arrival in Hainan was 3.15 卤2.67 days.Compared with the Hainan population group, the incidence rate of acute ST-segment elevation myocardial infarction (70.56%(139/197)vs 51.722) was higher in Migratory Bird population [70.56%(139/197)vs 51.722], the ratio of coronary artery disease with single vessel and double vessel was higher than P0.009, the proportion of thrombus aspiration was high (P 0.008), and the number of stents was less P0. 007.The proportion of cardiogenic shock after birth was higher than that of cardiogenic shock (12.69 vs 3.45P 0.044) and the death rate of cardiogenic shock (16.24 vs 3.45 P0.022).Conclusion: acute ST-segment elevation myocardial infarction has a high incidence rate, simple lesions, more thrombus aspiration and poor prognosis in AMI patients.
【作者单位】：中国人民解放军总医院心血管内科;中国人民解放军总医院海南分院心血管内科;
【基金】：国家自然科学基金(81500269) 三亚市医疗卫生科技创新项目(2014YW28) 中国人民解放军总医院扶持基金(2015FC-TSYS-1023)
【分类号】：R542.22

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