摘要
本文根据209例急性心肌梗塞病人住院不同时期内部分临床,心电图和酶学检查资料,利用单因素和多因素(逐步回归与逐步判别分析)对其进行了出院后第一年的预后研究。发现梗塞史、梗塞部位、室内传导阻滞、住院后期复杂室性心律失常、出院时心功能和 LDH 峰值共6项指标具有重要的独立预后意义。并据此建立起两类判别函数。对死亡病人的判别正确率为77%,对存活病人的判别正确率达97%。达到了区分高危和低危病人的目的,为二级防治提供了重点方向。
Clinical variables and those obtained by electrocardiographic and enzymatic te-chniques from different periods in the hospitalization course were studied retrospec-tively in a series of 209 patients discharged from hospital after an episode of acutemyocardial infarction.The prognostic value of the data was assessed by univariateand multivariate analyses.The best correlation to the prognosis in the first yearafter discharge was found for previous myocardial infarction,location of infarction,intraventricular block,complex ventricular arrhythmias in the late hospitalization,NYHA functional class on discharge and LDH peak level.The discriminant functionswhich were established according to the combination of the 6 variables identified77% of the death and 97% of the survivors.The sensitivity and specificity weresatisfactory.In conclusion,this approach can identify a small specificity of high risk patients anda large group with low risk in a large population.It also implicates that it is essen-tial to cope with cardiac dysfunction,ventricular arrhythmias,rate of reinfarctionin the secondary prevention for the high risk patients,if we want to improve thepatient;s outcome in the first year after discharge.
出处
《天津医药》
CAS
1990年第5期264-269,共6页
Tianjin Medical Journal
