急性心肌梗死患者入院临床特征与近期预后的相关性

摘要

目的：分析急性心肌梗死（AMI）患者的入院临床特征与近期预后结局的相关性。方法：回顾性分析因初发 AMI住院治疗患者108例的临床资料，依据是否发生主要不良心脏事件（MACE）分为：事件组（61例）和非事件组（47例），随访1年。收集、分析并比较两组患者的临床特征，以及 AMI临床特征与 MACE发生率的相关性。结果：与非事件组相比，事件组患者的平均年龄较大，平均动脉压（MAP）较高，左室射血分数（LVEF）降低，左室舒张末期内径（LVEDd）、Killip2级以上比例、Grace评分、多支病变增加，差异均有统计学意义（P＜0.05～＜0.01）。单因素相关分析显示年龄、MAP、LVEF、Killip2级以上比例、Grace评分、多支病变率与 MACE发生率存在相关性（P＜0.05～＜0.01）；经多因素 Logistic回归分析显示，年龄（OR＝0.827）、LVEF（OR＝0.624）、Grace评分（OR＝0.589）、多支病变率（OR＝0.461）是 AMI患者发生 MACE的危险因素（P均＜0.05）。结论：高龄、低左室射血分数、Grace评分高以及多支病变是急性心肌梗死患者近期发生主要不良心脏事件的高危因素。%Objective:To analyze the correlation betWeen clinical features at admission and recent prognostic outcome in patients With acute myocardial infarction (AMI).Methods:The data of 108 patients admitted because of primary AMI Were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE)or not after discharge,they Were divided into event group (n=61)and non-event group (n=47).Clinical features such as Gender,age etc.of tWo groups Were collected,analyzed and compared.After one-year folloW-up,correlations betWeen clinical feature indexes and MACE incidence Were analyzed.Results:Compared With non-event group, there Were significant increase in mean age,mean arterial pressure (MAP),left ventricular end-diastolic dimension (LVEDd),percentage of> Killip class 2,Grace score and multi-vessel coronary disease,and significant decrease in left ventricular ejection fraction (LVEF)in event group,P<0.05~<0.01. Single factor correlation analysis indi-cated that age,MAP,LVEF,percentage of > Killip class 2,Grace score and multi-vessel coronary disease rate Were correlated With MACE incidence rate (P<0.05~<0.01);multi-factor Logistic regression analysis indicated that age (OR=0.827),LVEF (OR=0.624),Grace score (OR=0.589)and multi-vessel coronary disease rate (OR=0.461)Were risk factors for MACE in AMI patients,P<0.05 all.Conclusion:Advanced age,loW left ven-tricular ejection fraction,higher Grace score and more multi-vessel coronary disease are high risk factors for recent occurrence of major adverse cardiovascular events in patients With acute myocardial infarction.