急性心肌梗死患者住院死亡危险因素分析.docVIP

急性心肌梗死患者住院死亡危险因素分析 　　 　　 　　[摘要] 目的 探讨急性心肌梗死（AMI）患者住院死亡的独立危险因素。 方法 收集本院2008年10月～2013年10月收治的463例AMI患者的临床资料，其中存活（存活组）384例，死亡（死亡组）79例，采用单因素及多因素Logistic回归分析筛选AMI患者住院死亡的独立危险因素。 结果 两组患者的性别、年龄、吸烟史、既往病史、心率、收缩压、肌钙蛋白T（cTnT）峰值、肌酸激酶同工酶（CK-MB）峰值、空腹血糖、肌酐（Cr）、高密度脂蛋白胆固醇（HDL-C）、超敏C反应蛋白（hs-CRP）、N-端脑利钠肽前体（NT-proBNP）、梗死部位、Killip分级、左心室射血分数（LVEF）、室性心律失常及再灌注等方面比较，差异有统计学意义（P＜0.05）。Logistic回归分析显示年龄、糖尿病、陈旧性心肌梗死（OMI）、心率、收缩压、cTnT峰值、Cr峰值、室性心动过速及心室颤动、Killip分级、LVEF及再灌注治疗与AMI患者住院死亡相关。 结论 高龄、糖尿病及OMI病史、心率增快、cTnT及Cr升高、出现室性心动过速及心室颤动、Killip分级高是AMI患者住院死亡的独立危险因素，收缩压、LVEF及再灌注治疗为保护性因素。 　　[关键词] 急性心肌梗死；危险因素；死亡；住院期 　　[中图分类号] R542.2+2[文献标识码] A[文章编号] 1674-4721（2014）03（c）-0050-03 　　 　　Analysis of independent risk factors of the mortality in-hospital patients with acute myocardial infarction 　　PAN Wei-ying ZHANG Wei-yan 　　Department of Medicine,the Second People′s Hospital of Luohe City in Henan Province,Luohe 462300,China 　　[Abstract] Objective To explore the independent risk factors of the mortality in-hospital patients with acute myocardial infarction (AMI).Methods The clinical data of 463 cases of patients with AMI in our hospital from October 2008 to October 2013 were collected,in whom survival (survival group) 384 cases,death (death group) 79 cases,the independent risk factors were selected by univariate analysis and multivariate Logistic regression analysis.Results The gender,age,smoking history,medical history,heart rate,systolic blood pressure,cardiac troponin T (cTnT) and creatine kinase (CK-MB) peak,fasting plasma glucose,creatinine (Cr),high density lipoprotein cholesterol (HDL-C),high-sensitivity C-reactive protein (hs-CRP),N-terminal pro-brain natriuretic peptide precursor (NT-proBNP),infarct location,Killip classification,left ventricular ejection fraction (LVEF),ventricular arrhythmias and re-comparison of perfusion in two groups of patients,the difference was significant (P0.05).Logistic regression analysis showed that age,diabetes,old myocardial infarction (OMI),heart rate ,systolic bl