摘要
目的:调查急性ST段抬高性心肌梗死(STEMI)患者的远期死亡率,并探讨影响远期死亡率的危险因素。方法:采用回顾性分析,连续入选确诊为STEMI收入北京大学第三医院心脏重症监护室,并存活出院的患者241例,根据出院后存活情况分为存活组(197例)和死亡组(44)例,平均随访(4.3±1.6)年。采集患者的性别、年龄、高血压史、糖尿病史、脑梗死史、吸烟史、心肌梗死部位、急诊PCI、肌酐值、空腹血糖、LDL、HDL、游离T3水平等入院基本资料,分析两组之间的差异。结果:单因素分析显示,年龄、女性、糖尿病史、脑梗死史、肌酐、低T3综合征与远期死亡呈正相关性(P<0.05),而急诊PCI与远期死亡呈负相关性(P<0.05);多因素分析显示,仅年龄(HR=1.076,P<0.001)、糖尿病史(HR=2.193,P<0.05)、低T3综合征(HR=5.807,P<0.001)是STEMI患者远期死亡的独立危险因素,急诊PCI降低了STEMI患者远期死亡的风险(HR=0.349,P<0.05)。结论:高龄、糖尿病史、低T3综合征是增加STEMI患者远期死亡率的独立危险因素,急诊PCI是降低STEMI患者远期死亡率的保护性因素。
Objective：To investigate long-term mortality in patients with acute ST-segment elevation myocardi- al infarction （STEMI）, and to explore the risk factors. Method： All 241 cases with acute STEMI who enrolled in Peking University Third Hospital Cardiac Intensive Care Unit and survived were selected, of which 197 survived （survival group） and 44 dead （survival group）. The average follow-up time was （4. 3 ± 1.6） years. The data about age, gender, medical history of hypertension, diabetes, cerebral infarction, smoking and localization of MI, emergency PCI, creatinine, fasting glucose, LDL, HDL, free T3 level and other informations in two groups were compared. Result： Univariate analysis showed that age, female, diabetes, cerebral infarction, creatinine, low T3 syndrome positively associated with long-term mortality （P〈0. 05）, and emergency PCI negatively associated with long-term mortality （P〈0. 05）. Multivariate analysis showed that age （FIR= 1. 076, P〈0. 001）, diabetes （FIR= 2. 193, Pc（0. 05） and low T3 syndrome （HR=5. 807, P〈0. 001） were independent predictors for long-term mor- tality in STEMI. Emergency PCI reduced the risk of death in STEMI patients （HR=0. 349, P〈0.05）. Conclu- sion： Age, diabetes, low Ts syndrome are independent risk factors for long-term mortality in patients with STE- MI. Emergency PCI is a protective factor for reducing long-term mortality in patients with STEMI.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2014年第4期308-311,共4页
Journal of Clinical Cardiology
关键词
急性心肌梗死
死亡率
危险因素
acute myocardial infarction
mortality
risk factors
