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目的:探讨湛江地区急性心肌梗死(AMI)患者近期死亡的独立危险因素。方法:将2009年12月至2014年11月湛江中心人民医院收治的578例AMI患者纳入研究,分析入选患者年龄、性别、既往史(糖尿病史、高血压病史、高脂血症病史、脑血管意外病史、心力衰竭病史)、患病季节、首诊心率、LVEF值以及AMI部位等基本资料,随访患者近期(住院后30 d)死亡例数。结果:578名AMI患者中208例(35.29%)近期死亡。年龄大、女性、糖尿病史、脑血管意外病史、患病季节为冬春、首诊心率越快、LVEF值越低、AMI部位为前侧壁等AMI患者的死亡风险高。logistic回归分析结果显示,年龄≥50岁是AMI患者近期病死的重要独立预测因素,其他预测因素还包括冬春患病、前侧壁AMI、LVEF<40%和脑血管意外病史。结论:年龄≥50岁、冬春患病、前侧壁AMI、LVEF<40%和脑血管意外病史是急湛江地区急性心肌梗死患者近期死亡的独立危险因素,应予以足够重视。
Objective: To explore the independent risk factors of recent death in patients with acute myocardial infarction (AMI) in Zhanjiang area. Methods: A total of 578 patients with AMI who were admitted to Zhanjiang Central People’s Hospital from December 2009 to November 2014 were enrolled in the study. Their age, sex, past history (history of diabetes mellitus, history of hypertension, history of hyperlipidemia, cerebrovascular Accidental history, heart failure history), prevalence season, first visit heart rate, LVEF and AMI sites and other basic information, follow-up of patients in the recent (30 days after hospitalization) number of deaths. Results: Of the 578 AMI patients, 208 (35.29%) recently died. Age, women, history of diabetes mellitus, history of cerebrovascular accident, winter and spring prevalence, higher heart rate at first visit, lower LVEF and higher risk of death from anterior AMI. Logistic regression analysis showed that age ≥50 years old was an important independent predictor of recent mortality in AMI patients. Other predictors were winter and spring prevalence, anterior wall AMI, LVEF <40% and history of cerebrovascular accident. Conclusion: The prevalence of winter and spring, AMI, LVEF <40%, and history of cerebrovascular accident in patients with age ≥50 years of age is an independent risk factor for recent death in patients with acute myocardial infarction in Zhanjiang, which should be given enough attention.