急性前壁心肌梗死患者3年随访及相关因素分析-全科医学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要············································································· （1） 英文摘要············································································· （2） 正文····················································································（4） 前言················································································ （4） 材料与方法······································································· （5） 结果················································································ （7） 讨论················································································ （10） 结论················································································ （15） 参考文献·········································································· （15） 文献综述············································································· （19） 参考文献············································································· （29） 缩略语表············································································· （31） 攻读学位期间发表文章情况····················································· （32） 个人简历············································································· （33） 致谢··················································································· （34） 1内蒙古医科大学硕士研究生学位论 1 内蒙古医科大学硕士研究生学位论文（2015） 中 文 摘 要 目的：通过随访急性前壁心肌梗死患者三年预后的情况，分析性别、吸烟、高血压、 糖尿病、血脂异常、血运重建及用药情况对预后的影响。为今后改善 AMI 患者预后，提 高患者生活质量提供帮助。 方法：采用回顾性分析方法，收集 2009 年 1 月至 2011 年 12 月在我院急诊内科住 院且符合随访标准的急性前壁心肌梗死患者 244 例，通过电话和门诊随访，得到三年预 后结果，剔除随访不到者 27 例，入选病例资料共 217 例，分析性别、吸烟、高血压、 糖尿病、血脂异常等指标、血运重建及用药情况对患者预后的影响，随访终点为患者免 于不良心脏事件的发生率，包括心源性死亡、再发心肌梗死、再发心绞痛、心力衰竭、 心律失常。 结果：（1）分析显示：性别、吸烟、高血压、糖尿病、血脂异常、梗死部位、血运 重建是影响 AMI 预后的因素。（2）Logistic 回归分析显示：血运重建者比无血运重建者 远期预后好，发生不良心脏事件少。（3）Kaplan-Meier 曲线生存分析显示：血运重建患 者生存时间、生存率明显优于无血运重建者。（4）二级预防用药影响 AMI 患者的预后。 结论：通过对急性前壁心肌梗死患者三年的随访，发现影响患者预后的因素有：（1） 急性前壁心肌梗死的患者，梗死相关血管为 LAD，LAD 病变更易发生心功能不全。（2） 进行再灌注治疗，血运重建患者的预后明显优于无血运重建患者，发生不良心脏事件少， 远期生存率好。（3）性别、吸烟、高血压、糖尿病、血脂异常均对 AMI 患者的预