女性急性冠脉综合征患者并发心肌梗死后综合征的危险因素分析

摘要

目的 分析女性急性冠脉综合征(ACS)患者并发心肌梗死后综合征(PMIS)的危险因素.方法纳入258例女性ACS患者并发PMIS的患者24例,将发生PMIS组和未发生PMIS组患者资料进行对比,找出差异因素,对差异因素进行多因素Logistic回归分析,得出女性ACS患者并发PMIS的独立危险因素.结果 258例女性ACS患者并发PMIS的患者24例,比例为9.30%.结果显示发生PMIS组患者年龄、梗死面积、纤维蛋白原(FIB)水平、肌酸激酶同工酶(CK-MB)水平和肌钙蛋白I(cTnI)水平分别为[(64.95±4.95)岁、(11.65±1.52)cm2、(6.91±1.86)g/L、(36.91±2.46)ng/L、(8.91±1.54)ng/L]均高于未发生PMIS组[(56.18±4.83)岁、(8.83±1.49)cm2、(5.41±1.58)g/L、(33.88±2.25)ng/L、(6.40±1.17ng/L)](t=8.452、8.814、4.354、6.229、9.695,均P<0.05),有吸烟喝酒嗜好的患者比例、有基础疾病患者比例、有肺部慢性疾病患者比例、有心肌梗死史患者比例、Killip分级为Ⅲ-Ⅳ的患者比例分别为(16.67%、37.50%、20.83%、66.67%、66.67%),均高于未发生PMIS组(4.70%、11.97%、8.97%、31.20%、31.20%)(x2=5.692、11.553、4.378、12.120、7.172,均P＜0.05).多因素检验结果显示基础疾病、心肌梗死史、梗死面积、Killip分级、CK-MB水平和cTnI水平为女性ACS患者并发PMIS的独立危险因素.结论 合并基础疾病、心肌梗死死面积较大、Killip分级较高、高CK-MB水平和高cTnI水平会增加女性ACS患者并发PMIS的危险.%Objective To analyze the risk factors of postmyocardial infarction syndrome(PMIS)to female patients with acute coronary syndromes(ACS).Methods 258 female patients with ACS complicated with myocardial infarction were selected, of whom 24 patients with PMIS.The clinical data of the two groups were compared and made Logistic regression analysis with different factors to get independent risk factors for PMIS.Results Of 258 female patients with ACS complicated with myocardial infarction, 24 patients with PMIS, the proportion was 9.30%.The age, infarct size, fibrinogen(FIB) level, creatine kinase isoenzymes(CK-MB) level and troponin I(cTnI) level of PMIS group were (64.95±4.95)years old,(11.65±1.52)cm, (2,6.91±1.86)g/L,(36.91±2.46)ng/L,(8.91±1.54)ng/L,respectively, which were higher than those in non-PMIS group[(56.18±4.83)years old,(8.83±1.49)cm2,(5.41±1.58)g/L,(33.88±2.25)ng/L,(6.40±1.17)ng/L](t=8.452,8.814,4.354,6.229,9.695,all P＜0.05).The proportion of patients with smoking and drinking habits, proportion of patients with underlying diseases, proportion of patients with chronic pulmonary disease, proportion of patients with heart and stalk history, proportion of patients with Killip grade Ⅲ-Ⅳ were 16.67%,37.50%,20.83%,66.67%,66.67%,respectively,which were higher than those in non-PMIS group (4.70%,11.97%,8.97%,31.20%,31.20%, x2=5.692,11.553,4.378,12.120,7.172,all P＜0.05).Logistic regression analysis showed that basic disease, history of myocardial infarction, infarct size, Killip classification, CK-MB level and cTnI level were independent risk factors for PMIS.Conclusion The combination of basic disease, history of myocardial infarction, larger infarct size, higher Killip classification, high CK-MB level and high cTnI level can increase the risk of PMIS in female patients with ACS.