潘慧超, 刘建平, 张丽华, 金 艳. 影响急性心肌梗死近期预后的因素[J]. 心脏杂志, 2013, 25(6): 657-660.
    引用本文: 潘慧超, 刘建平, 张丽华, 金 艳. 影响急性心肌梗死近期预后的因素[J]. 心脏杂志, 2013, 25(6): 657-660.
    Factors influencing the shortterm prognosis of patients with acute myocardial infarction[J]. Chinese Heart Journal, 2013, 25(6): 657-660.
    Citation: Factors influencing the shortterm prognosis of patients with acute myocardial infarction[J]. Chinese Heart Journal, 2013, 25(6): 657-660.

    影响急性心肌梗死近期预后的因素

    Factors influencing the shortterm prognosis of patients with acute myocardial infarction

    • 摘要: 目的:观察与分析影响急性心肌梗死(AMI)患者近期预后的因素。方法:回顾性分析2010年1月~2012年1月我院心内科因初发急性心肌梗死接受治疗的患者108例,收集血糖、血脂、肾功能、肌酸激酶(CK)、脑钠尿肽(BNP)、左室射血分数(LVEF)、入院Grace评分和冠脉造影结果进行分析。结果:事件组患者血清三酰甘油、尿素氮、尿酸平均水平均高于非事件组(P<0.05,P<0.01)。高三酰甘油、高空腹血糖发生率高于非事件组(P<0.05);事件组各时间点BNP高于非事件组(P<0.01),入院第2天两组BNP均明显升高(P<001),非事件组CK显著升高(P<0.01);入院1周时非事件组BNP明显回落(P<0.05),事件组CK值降幅明显低于非事件组(P<0.01)。事件组LVEF<55%患者比例及入院Grace评分高危患者比例高于非事件组(P<0.01),多支病变罹患率亦高于非事件组(P<0.01)。多因素非条件logistic回归分析(α= 0.1) 结果显示Grace分级、LVEF 、入院即刻与入院1周BNP、入院第2天CK为AMI近期预后的独立预测因子。结论:BNP、CK动态变化、入院Grace评分、LVEF 是AMI近期预后的独立预测因子。

       

      Abstract: AIM:To study the factors influencing the shortterm prognosis in patients with acute myocardial infarction (AMI) and to assess its predictive value with coronary angiographic findings. METHODS: A retrospective analysis of 108 AMI patients in the critical care unit (CCU) from January 2010 to January 2012 in our hospital was conducted for glucose, lipids, renal function, fibrinogen, creatine kinase, Btype natriuretic peptide and coronary angiographic findings. RESULTS: Average level of serum triglycerides, fasting glucose, average serum urea nitrogen level and average serum uric acid level in event group were higher than those in nonevent group. The mean BNP levels of each time point in event group were all higher than those in nonevent group. The percentage of patients with multivessel lesions in event group was higher than in nonevent group. CONCLUSION: The risk of adverse cardiac events in AMI patients increases with increasing triglycerides. Fasting glucose on admission is one of the high risk factors for cardiac events. Elevated level of serum uric acid and urea nitrogen are shortterm adverse prognostic risk factors for AMI. BNP is a risk for death and cardiovascular events in patients with AMI. Multivessel lesions suggest a high incidence of cardiac events and patients with infarctionrelated artery in LAD have a poorer prognosis than patients with infarctionrelated artery in RCA or LCX.

       

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