急性ST段抬高型心肌梗死患者短期预后的影响因素

发布时间：2018-04-19 21:00

  本文选题：急性ST段抬高型心肌梗死 + 预后　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨急性ST段抬高型心肌梗死患者短期预后的影响因素。方法:连续收集2012年至2016年心血管科收住的急性STEMI患者并进行为期30天的随访,一共纳入348例患者,根据患者有无发生主要不良心脏事件分为事件组(106例)和对照组(242例),通过对比两组的基本情况、实验室检查、心电图和影像学检查及治疗方法,分析影响两组间预后因素的差异。结果:对两组急性ST段抬高型心肌梗死患者进行单因素分析显示:年龄、首诊心率、收缩压、舒张压、血钾、尿素氮、血肌酐、尿酸、随机血糖、高密度脂蛋白、C-反应蛋白、D-二聚体、糖化血红蛋白、糖尿病病史、心肌梗死病史方面的差异均有统计学意义。而性别、院前延误时间、吸烟、住院天数、胆固醇、甘油三脂、低密度脂蛋白、脑钠肽、同型半胱氨酸、前壁心肌梗死、左室缩短分数、左室射血分数、高血压病史、脑血管意外病史、溶栓治疗的差别无统计学意义。对上述有意义的指标纳入多因素Logistic回归表明,随机血糖7.0mmol/l(OR=1.228,95%CI:1.198~1.240,P0.001)、首诊心率76次/分(OR=1.048,95%CI:1.024~1.073,P0.001)、血尿素氮5.3mmol/l(OR=1.136,95%CI:1.007~1.281,P=0.038)、C-反应蛋白7.35mg/l(OR=1.017,95%CI:1.006~1.028,P=0.002)均是发生主要不良心脏事件的危险因素,首诊舒张压75mmHg(OR=0.942,95%CI:0.915~0.969,P0.001)、PCI治疗(OR=0.542,95%CI:0.331~0.889,P=0.015)是保护因素。结论:随机血糖高、心率快、肾功能不全、炎症均是急性心肌梗死患者发生主要不良心脏事件的危险因素。维持舒张压、PCI治疗有益于急性心肌梗死患者的短期预后,而与既往高血压病史相关性不明显。
[Abstract]:Objective: to investigate the influence factors of short-term prognosis in patients with acute St-segment elevation myocardial infarction. Methods: a total of 348 patients with acute STEMI were collected from 2012 to 2016 and followed up for 30 days. According to the occurrence of major adverse cardiac events, the patients were divided into two groups: the event group (106 cases) and the control group (242 cases). By comparing the basic conditions of the two groups, laboratory examination, electrocardiogram and imaging examination and treatment, The difference of prognostic factors between the two groups was analyzed. Results: univariate analysis showed that age, heart rate, systolic blood pressure, diastolic blood pressure, blood potassium, urea nitrogen, serum creatinine, uric acid, and random blood glucose in two groups of patients with acute ST-segment elevation myocardial infarction. There were significant differences in D-dimer, glycosylated hemoglobin, history of diabetes and myocardial infarction. Sex, pre-hospital delay, smoking, hospitalization days, cholesterol, triglyceride, low density lipoprotein, brain natriuretic peptide, homocysteine, anterior wall myocardial infarction, left ventricular shortening score, left ventricular ejection fraction, hypertension history, There was no significant difference in the history of cerebrovascular accident and thrombolytic therapy. 瀵逛笂杩版湁鎰忎箟鐨勬寚鏍囩撼鍏ュ�氬洜绱燣ogistic鍥炲綊琛ㄦ槑,闅忔満琛，

本文编号：1774697