摘要
目的分析陈旧性脑梗死对急性心肌梗死（AMI）患者住院死亡的影响。方法回顾分析首都医科大学宣武医院2002--2009年连续住院的3572例AMI患者资料。结果3572例AMI患者中伴陈旧性脑梗死564例（15．8％），与不伴陈旧性脑梗死相比，年龄较大[（69．4±9．9）岁比（64．2±12．9）岁，P=0．000]。高血压、糖尿病、陈旧性心肌梗死、非ST段抬高性心肌梗死比例较高（71．0％比57．3％，41．0％比25．7％，12．9％比9．5％，14．9％比10．7％，P〈0．01），且住院病死率较高（16．5％比10．0％，P=0．000）。陈旧性脑梗死增加住院死亡（OR1．368，P=0．022），且独立于年龄（OR1．048），性别（OR1．148）、糖尿病（OR1．337）、陈旧性心肌梗死（OR1．294）、广泛前壁心肌梗死（OR1．888）、介入性治疗（OR0．506）等因素。结论陈旧性脑梗死增加AMI患者住院死亡风险。
Objective To investigate the impact of prior cerebral infarction （PCI） on in-hospital mortality in patients with Acute Myocardial Infarction （AMI）. Methods A retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan. 1 to 2009 Dec. 31 were performed. Results There were 564 patients （ 15.8% ） with PCI. Compared with the group of without PCI, the group with PCI were substantially older [ （69. 4 ± 9. 9） vs （64. 2 ± 12. 9） years, P = 0. 000 ] , and had a higher prevalence of hypertensive disease, diabetes mellitus, prior myocardial infarction （MI） and non-ST-segment elevation myocardial infarction （NSTEMI） （respectively, 71.0% vs57.3%; 41.0%vs 25.7%,12.9% vs 9.5%; 14. 9%vs 10.7%, P〈0.01）, and a higher in-hospital mortality （16. 5% vs 10. 0% , P = 0. 000）. Univariate analysis demonstrated that in-hospital mortality associated with age, sender, extensive anterior MI, anterior MI, diabetes mellitus, prior cerebral infarction, prior myocardial infarction, coronary angiography and percutaneous coronary intervention. Logistic regression analysis found that risk factors were age, extensive anterior MI, anterior MI, diabetes mellitus and prior cerebral infarction, and protective factors were coronary angiography and percutanous coronary intervention. PCI was independently associated with in-hospital mortality, OR 1. 368, 95% CI 1. 047-1. 787, P = 0. 022. Conclusion In patients with acute myocardial infarction, the presence of PCI increases the risk of worse in-hospital outcome.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第9期747-749,共3页
Chinese Journal of Internal Medicine
关键词
心肌梗死
脑梗死
死亡原因
Myocardial infarction
Brain infarction
Cause of death
