β受体阻滞剂不耐受与急性冠状动脉综合征后临床转归的相关性-临床医学(内科学)专业论文.docxVIP

I I β受体阻滞剂不耐受与急性冠状动脉综合征后临床转归的相关性 中文摘要 β受体阻滞剂不耐受与急性冠状动脉综合征后临床转归 的相关性 中文摘要 目的：探讨β受体阻滞剂不耐受与急性冠状动脉综合征(ACS)患者临 床转归的相关性。 方法：本研究共纳入222例符合Killip分级Ⅰ级或Ⅱ级住院患者。分别 收集患者入院时的基础数据，如性别、年龄、血压、心率、血糖、肌酐 、肌钙蛋白、合并症、吸烟、ST段是否上抬、既往ACS史、药物治疗史 等数据，并对这些数据进行统计分析。随后根据ACC/AHA指南和中华 医学会心血管病分会标准给予患者β受体阻滞剂，在患者出现不耐受时 停药。并对这些患者进行为期6个月的随访，观察患者出现的任何临床 转归。采用logistic回归对β受体阻滞剂和临床转归与上述因素的相关性 进行分析。 结果：β受体阻滞剂不耐受出现于54例患者。校正年龄、性别、血压 和肾功能后，β受体阻滞剂与无既往使用他汀类药物(OR：2.16，95%CI ：1.27-3.69，P=0.004)和Killip分级Ⅱ级(OR：2.53，95%CI：1.34- 4.75，P=0.004)有关，但与ST段上抬无关(OR：0.82，95%CI：0.49- 1.36，P=0.487)。年龄(OR：1.06，95%CI：1.03– 1.10，P0.001)和β受体阻滞剂不耐受(OR：4.5，95%CI：2.15- 9.39，P0.001)与发生死亡的最高风险有关。 结论：β受体阻滞剂不耐受与急性冠状动脉综合征患者的无既往他汀 II II 中文摘要 β受体阻滞剂不耐受与急性冠状动脉综合征后临床转归的相关性 类药物使用和Killip分级Ⅱ级有关，并且在6个月内存在发生死亡的较高 风险。 关键词：急性冠状动脉综合征；β受体阻滞剂；转归；死亡率；依从 性 作 者：杨 磊 指导教师：蒋廷波 PAGE PAGE IV β受体阻滞剂不耐受与急性冠状动脉综合征后临床转归的相关性 英文摘要 The associations between the intolerance to β blocker and the clinical outcomes in patients with acute coronary syndrome Abstract Purpose: To investigate the associations between the intolerance to β blockers and the clinical outcomes in patients with acute coronary syndrome (ACS). Methods: A total of 222 patients with ACS in Killip class Ⅰ or Ⅱ were included in this current study. Anthropometric and clinical data were collected at admission, such as gender, age, blood pressure, heart rate, serum glucose, creatinine and troponin, commodities, the presence of ST elevation, smoking status, as well as the previous history of ACS and medication. Paired t test was applied to explore the differences of these data. Then, β blockers were given to the included patients based on the ACC/AHA guidelines and China national criteria. If the patient experienced any symptoms related to the intolerance to β blockers, the β blockers was discontinued immediately. All the patients were followed for 6 months for any clinical outcomes. Logistic regression analysis were used to determine the associations between the intolerance to β blockers and th