目的 调查北京大学第三医院延庆医院急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者5年生存率.方法 对2002年8月至2010年12月于北京大学第三医院延庆医院就诊的691例STEMI患者进行5年随访,终点事件是全因死亡.采用Kaplan-Meier法绘制5年生存曲线,多因素Cox回归分析5年内死亡的预测因素.结果 691例患者中442例(64.0％)未接受直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI),249例(36.0％)接受直接PCI.未接受直接PCI和接受直接PCI的患者5年生存率分别为73.8％ 和93.6％.未接受直接PCI患者死亡的预测因素为女性、年龄、慢性阻塞性肺疾病、住院期间心功能Killip分级≥Ⅱ级、前壁心肌梗死和未接受择期PCI,而接受直接PCI患者死亡的预测因素是年龄和住院期间消化道出血.结论 接受直接PCI患者5年生存率显著高于未接受直接PCI的患者.两组患者死亡的预测因素有所不同.%Objective To investigate 5-year survival after ST-segment elevation myocardial infarction(STEMI)in Beijing Yanqing district. Methods A total of 691 STEMI patients admitted to Beijing Yanqing hospital from August 2002 to December 2010 were followed up for as long as 5 years. The end point was all cause death. Five-year survival curve was computed for patients who had received primary percutaneous coronary intervention(pPCI)and patients who had not received pPCI. Predictors of death within 5 years were identified by multivariable cox regression analysis. Results In 691 patient,442 patients(64.0％)had not received pPCI,and 249 patients(36.0％)had received pPCI. The 5-year survival rates were 73.8％ and 93.6％in patients who had not received pPCI and patients who had received pPCI separately. The predictors of death within 5 years in patients who had not received pPCI were female,age,chronic obstructive pulmonary disease, Killip's class ≥ 2 in hospital,myocardial infarction of anterior wall and not receiving elective PCI,while the predictors in patients who had received pPCI were age and gastrointestinal bleeding. Conclusions The 5-year survival rate in patients who had received pPCI was obviously higher than in patients who had not received pPCI. The predictors of death within 5 years were different in the two groups.
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