摘要
目的分析稳定型冠心病(SCAD)患者急性心肌梗死(AMI)发生的危险因素及临床应对措施。方法回顾性选取2023年1月—2024年1月于齐齐哈尔医学院附属第一医院规律随访的237例SCAD患者为研究对象,根据患者于随访过程中是否发生AMI将其分为AMI组和稳定组,收集两组患者的人口学资料、疾病相关特征及生化指标,采用多因素Logistic回归分析SCAD患者发生AMI的危险因素,并构建(ROC)分析各因素的预测价值。结果经随访,237例SCAD患者中,34例患者发生AMI,占比14.35%;203例未发生AMI,占比85.65%。两组性别、病程、吸烟、饮酒、糖尿病、药物治疗、就诊时白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);两组年龄、血压、6个月随访时血清炎症因子(IL-6、TNF-α)水平比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄偏高、高血压、IL-6较高、TNF-α较高是SCAD患者发生AMI的危险因素(P<0.05)。ROC曲线分析显示,年龄偏高、高血压、IL-6较高、TNF-α较高的AUC值分别为0.772、0.801、0.853及0.883,均对SCAD患者发生AMI具有预测价值,其中IL-6、TNF-α的预测价值较高。结论SCAD患者的AMI发生受年龄、血压水平及炎症因子(IL-6、TNF-α)水平等因素影响,临床应对影响因素加以关注预防,降低AMI发生风险。
Objective To analyze the risk factors and clinical countermeasures for the occurrence of acute myocardial infarction(AMI)in patients with stable coronary artery disease(SCAD).Methods A retrospective study was conducted on 237 SCAD patients who were regularly followed up at the First Affi liated Hospital of Qiqihar Medical College from January 2023 to January 2024.The patients were divided into an AMI group and a stable group based on whether they experienced AMI during the follow-up process.Demographic data,disease-related characteristics,and biochemical indicators of the two groups of patients were collected.Multivariate Logistic regression was used to analyze the risk factors for SCAD patients to develop AMI,and receiver operating characteristic(ROC)curves were constructed to analyze the predictive value of each factor.Results After follow-up,among 237 SCAD patients,34 patients developed AMI,accounting for 14.35%;203 cases did not experience AMI,accounting for 85.65%;There was no signifi cant diff erence between the two groups in terms of gender,course of disease,smoking,drinking,diabetes,drug treatment,and the levels of interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)at the time of treatment(P>0.05);There was a statistically signifi cant diff erence(P<0.05)in the levels of serum infl ammatory factors(IL-6,TNF-α)between the two groups in terms of age,blood pressure,and 6-month follow-up.Multivariate logistic regression analysis showed that older age,hypertension,higher IL-6 levels,and higher TNF-αlevels were risk factors for AMI in SCAD patients(P<0.05).ROC curve analysis showed that the AUC values for age,hypertension,IL-6,and TNF-αwere 0.772,0.801,0.853,and 0.883,respectively,all of which have predictive value for the occurrence of AMI in SCAD patients,with IL-6 and TNF-αhaving higher predictive value.Conclusion The occurrence of AMI in SCAD patients is aff ected by age,blood pressure level and infl ammatory factor(IL-6,TNF-α)level,etc.Clinical attention should be paid to the infl uencing factors to prevent and reduce the risk of AMI.
作者
夏颖
丁天航
羡微微
崔东吉
陈西
张宝俊
曾丽艳
XIA Ying;DING Tianhang;XIAN Weiwei;CUI Dongji;CHEN Xi;ZHANG Baojun;ZENG Liyan(Department of Cardiology,First Affi liated Hospital of Qiqihar Medical College,Qiqihar Heilongjiang,161041,China)
出处
《中华养生保健》
2025年第19期70-73,共4页
CHINESE HEALTH CARE
基金
齐齐哈尔市科技计划联合引导项目(LSFGG-2024086)。
关键词
稳定型冠心病
急性心肌梗死
血压
白细胞介素-6
stable coronary artery disease
acute heart attack
blood pressure
interleukin-6
