摘要
目的对入住呼吸重症监护室(RICU)的重症肺炎患者发生急性心肌梗死(AMI)的危险因素进行分析.方法回顾性分析2015年1月1日至2017年12月31日期间于我院RICU住院的重症肺炎患者,根据其是否在住院期间发生AMI分为两组,收集两组患者的相关临床资料,采用统计软件进行分析.结果共纳入患者104例,其中男性56例、女性48例,平均年龄(73.26±7.23)岁;诊断为AMI患者34例(32.7%),其中男性15例、女性19例,平均年龄(74.12±6.22)岁.两组患者在性别、年龄以及吸烟史、饮酒史等危险因素方面比较差异无统计学意义.单因素分析发现,AMI组患者与无AMI组比较,前者入院时降钙素原(PCT)水平高[(10.73±3.04)ng/ml比(8.04±4.15)ng/ml,P=0.001]、C反应蛋白(CRP)水平高[(63.51±21.69)mg/L比(55.52±26.09)mg/L,P=0.032]、血乳酸水平高[(1.64±0.58)mmol/L比(1.45±0.62)mmol/L,P=0.024]、脑钠肽(BNP)水平高[(1271.29±379.18)pg/ml比(1093.70±184.65)pg/ml,P=0.047]、急性生理学及慢性健康状况评分系统(APACHE)Ⅱ评分高(28.94±5.72比26.07±6.10),P=0.024)、血白蛋白低[(39.82±4.67)g/L比(42.57±4.42)g/L,P=0.014]、血肌酐高[(90.24±16.68)μmol/L比(81.47±21.52)μmol/L,P=0.041]、血糖高[(8.79±2.15)mmol/L比(7.76±2.37)mmol/L,P=0.011]以及使用呼吸机治疗的比例更高(50.0%比28.6%,P=0.049).多因素Logistic回归分析发现,高水平的PCT、血肌酐以及BNP是发生AMI的独立危险因素.结论重症肺炎患者发生AMI的比例很高,入院时高水平的PCT、血肌酐以及BNP是发生AMI的独立危险因素.
ObjectiveTo evaluate the risk factors of acute myocardial infarction(AMl)in severe pneumonia patients hospitalized in RICU.MethodsSevere pneumonia patients who hospitalized in RICU department of Beijing Shjitan Hospital were reviewed from January 1st 2015 to December 31st 2017;patients were divided into two groups according to the diagnosis of AMI or not;relative clinical information was collected and analyzed.Results 104 patients were enrolled with average age of(73.26±7.23)years;34(32.7%)patients were diagnosed with AMI There is no significant difference between the two groups regarding to the gender distribution,age,smoking and alcoholic history.Univariable analyse revealed that patients diagnosed with AMI were accompanied by higher level of procalcitonin(PCT)[(10.73±3.04)ng/ml vs.(8.04±4.15)ng/ml,P=0.001],C-reactive protein(CRP)[(63.51±21.69)mg/L vs.(55.52±26.09)mg/L.P=0.032],lactic acid[(1.64±0.58)mmol/L vs.(1.45H0.62)mmol/L,P=0.024],serum creatinine[(90.24±16.68)umol/Lvs.(81.47±21.52)umol/L,P=0.041],glucose[(8.79±2.15)mmol/L vs.(7.76±2.37)mmol/L,p=0.011],brain natriuretic peptide(BNP)[(1271.29±379.18)pg/ml vs.(1093.70±184.65)pg/ml,P=0.047],score of APACHE Ⅱ score(28.94±5.72 vs.26.07±6.10,P=0.024)and lower level of scrum albumin[(39.82±4.67)g/L vs.(42.57±4.42)g/L,P=0.014]with higher rate of ventilation therapy(50.0%vs.28.6%,P=0.049).Further Logistic analyses revealed that higher level of PCT,BNP and serum creatinine were the independent risk factors for APACHE Ⅱ in severe pneumonia patients.Conclusion The incidence rate of AMI is high in severe pneumonia patients and the higher level of PCT,BNP and serum creatinine were the independent risk factors for AMII in these patients.
作者
李龙
LI Long(Respiratory Department,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《中国心血管病研究》
CAS
2020年第7期601-604,共4页
Chinese Journal of Cardiovascular Research
