急性心肌梗死合并室间隔穿孔的近期预后因素.docVIP

精品论文 参考文献 急性心肌梗死合并室间隔穿孔的近期预后因素 付艳华 　　（郑州大学公共卫生学院 郑州大学第五附属医院 河南 郑州 450052） 　　【摘要】目的：探讨急性心肌梗死（AMI）合并室间隔穿孔（VSR）的近期预后因素。方法：选取并回顾性分析2005年1月—2014年5月于我院住院治疗的65例AMI合并VSR患者，根据患者发病后的存活期分为两组：S组（存活le;30d，34例）和L组（存活＞30d，31例），比较两组患者的年龄、性别构成比、病史及实验室检查结果，分析存活期le;30d的危险因素，采用Logistic多元回归分析方法，制定AMI合并VSR患者的近期预后危险评分。结果：S组与L组临床指标比较结果显示，女性、Killip分级ge;Ⅲ级、前壁心梗、无室壁瘤形成、室间隔穿孔发生在近心尖部和AMI发作至VSR确诊的时间（AMI-VSR时间）le;4d等方面差异有统计学意义（P均＜0.05）。Logistic多元回归??析结果显示，女性、Killip分级ge;Ⅲ级、前壁心梗、不合并糖尿病、无室壁瘤形成和AMI-VSR时间le;4d均为AMI合并VSR患者存活期le;30d的独立危险因素。结论：AMI合并VSR患者存活期le;30d的独立危险因素包括女性、Killip分级ge;Ⅲ级、前壁心梗、不合并糖尿病、无室壁瘤形成及AMI-VSR时间le;4d，对具有高危因素的患者应给予更积极有效的治疗。 　　【关键词】室间隔穿孔；心肌梗死；危险因素 　　【中图分类号】 R541 【文献标识码】A 【文章编号】2095-1752（2015）12-0077-02 　　The recent prognostic factors of acute myocardial infarction merger ventricular septal perforation 　　Fu Yanhua School of Public Health, Zhengzhou University；The Fifth Affiliated Hospital of Zhengzhou University,Hersquo;nan Province，Zhengzhou 450052，China 　　【Abstract】Objective To study the acute myocardial infarction (AMI) with ventricular septal perforation (VSR) recent prognostic factors. Methods Selection and retrospective analysis in January 2005 to May 2014 in our hospital treatment of 65 cases of AMI patients with combination of VSR. According to patients after onset of survival time was divided into two groups: group S (survival le; 30 d, 34 cases) and L group (survive gt; 30 d, 31 cases). Compare two groups of patients age, gender, history and laboratory results, using Logistic multivariate regression analysis method, making the recent prognosis of patients with risk score.Results Comparison results showed that women, Killip class acuity Ⅲ, anterior wall myocardial infarction, no aneurysm formation, ventricular septal perforation occurred in near apex, and onset of AMI and VSR diagnosed (AMI - time of VSR) aspects and so on 4 d or less difference was statistically significant (P lt; 0.05). Logistic multivariate regression analysis