摘要
目的探讨入院初期影响急性心肌梗死（AMI）患者并发肺炎的相关因素。方法以1993年1月至2006年6月收住解放军总医院的1443例AMI住院患者为对象，对比分析AMI合并肺炎组（159例）和非肺炎组（1284例）患者入院时的病史、临床表现、并发症等特点，以Logistic多因素逐步回归分析探讨AMI入院后并发肺炎的独立影响因素。结果Logistic多因素逐步回归分析表明年龄[比数比（0R）1．983，95％可信区间（CI）1．499-2．623]、冠心病病史（OR 1．566，CI 1．034～2．371）、入院时心率（OR 1．823，CI 1．452～2．287）、白细胞计数（OR 1．409，CI 1．071～1．853）、贫血（OR2．292，CI 1．482～3．543）、PCI治疗（OR 0．519，CI 0．327～0．824），并发心衰（OR3．264，CI 2．130～5．002）、室颤／室速（OR 2．347，CI 1．231～4．476）是AMI患者并发肺炎的独立影响因素。结论AMI患者入院时心率和白细胞计数升高，并发心衰、室颤／室速和贫血以及未进行PCI治疗者并发肺炎的危险性明显升高。
Objective To investigate the factors influencing pneumonia in hospitalized patients with acute myocardial infarction（AMI）. Methods A total of 1443 patients with AMI were admitted to the Chinese PLA General Hospital from Jan 1, 1993 to June 30, 2006. The patients were divided into two groups ： pneumonia group （159 cases） and non pneumonia group（1284 cases）. The clinical characteristics, risk factors, clinical treatment and complications were compared. Results The multivariate logistic regression analysis showed that the major determinants of pneumonia were the age [OR 1. 983, 95 % confidence interval （CI） 1. 499-2. 623], history of coronary heart disease （OR 1. 566, 95%CI 1. 034-2. 371）, heart rate （OR 1. 823, 95%CI 1. 452-2. 287）, white blood cell count（OR 1. 409, 95%CI 1. 071-1. 853）, complications of heart failure （OR 3. 264,95%CI 2. 130-5. 002）, ventricular tachycardia or fibrillation （OR 2. 347,95%CI 1. 231-4. 476）, anemia （OR 2. 292,95%CI 1. 482-3. 543） and percutaneous coronary intervention （OR 0. 519,95%CI 0. 327-0. 824）. Conclusion Increse in heart rate and leucocyte count on admission, complication of heart failure, ventriuclar fibrillation or tachycardia, anemia and without PCI treatment can significantly increase the risk for complication of pneamonia in AMI patients.
出处
《中华老年多器官疾病杂志》
2008年第1期16-18,22,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
