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目的:观察首次确诊为急性心肌梗死(AMI)患者的临床特征并分析不同性别人群的在入院治疗及院内短期预后的差异。方法:回顾性分析2010年2月至2012年4月在沈阳军区总医院心内科初次确诊为AMI的患者271例,并按性别分为两组,其中男性组180例,女性组91例,统计其临床特征、入院后的药物和手术治疗情况,以及院内并发症及预后情况,分析总结两组患者各自的特点和差异。结果:女性患者的年龄要大于男性患者(63±14vs71±11,P<0.001),且同时更易患有高血压等心血管疾病合并症(73.3%vs 58.2%,P<0.05)。女性患者的发病至入院治疗时间长于男性(P<0.001),且入院后行PCI治疗的比例要明显低于男性患者(67%vs 79.4%,P<0.05)。初步分析结果表明,女性患者的院内死亡率高于男性(11%vs 3.3%,OR:3.11,95%CI:1.53-7.15),但排除不均衡因素的影响后,男女患者的院内死亡率无明显差异(OR:2.11,95%CI:0.68-5.12)。结论:两性AMI患者的临床特征、入院后治疗及院内短期预后均存在一定差异。根据女性患者的临床特征和院内治疗及预后的现状,应进一步加强对女性高危人群的冠心病诊治知识普及和教育,且对入院后的女性患者应采取更为积极的药物和介入手术治疗手段,以改善预后。
OBJECTIVE: To observe the clinical features of patients with first diagnosis of acute myocardial infarction (AMI) and to analyze the differences in hospitalization and short-term hospital-based prognosis of different gender groups. Methods: A retrospective analysis of 271 patients with AMI who were initially diagnosed as AMI in the Department of Cardiology, Shenyang Military Region General Hospital from February 2010 to April 2012 was divided into two groups according to their gender, including 180 males and 91 females, Its clinical features, drug and surgical treatment after admission, complication and prognosis in hospital, and analyzed the characteristics and differences of the two groups of patients. Results: Female patients were older than male patients (63 ± 14 vs 71 ± 11, P <0.001), and were more likely to have comorbid cardiovascular events such as hypertension (73.3% vs 58.2%, P <0.05). The incidence of hospitalization in women patients was longer than that in men (P <0.001), and the percentage of PCI patients after admission was significantly lower than that of male patients (67% vs 79.4%, P <0.05). The preliminary analysis showed that the in-hospital mortality rate of female patients was higher than that of males (11% vs 3.3%, OR: 3.11, 95% CI: 1.53-7.15). However, after excluding the unbalanced factors, the in-hospital mortality rate Significant differences (OR: 2.11, 95% CI: 0.68-5.12). Conclusion: There are some differences in the clinical features, hospitalization and short-term hospital prognosis of patients with AMI. According to the clinical characteristics of female patients and the status of hospital treatment and prognosis, we should further strengthen the popularization and education of diagnosis and treatment of coronary heart disease in women at high risk, and take more aggressive drugs and interventional surgical treatment for female patients after admission, To improve the prognosis.