摘要
目的急性心肌梗死(acute myocardial infarction,AMI)多采用急诊经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗,疗效显著,但老年患者PCI术后易发生各类心脏事件,本研究分析老年AMI患者PCI术后预后的相关影响因素。方法回顾性分析2015-06-01-2017-08-31凤城市中心医院收治的183例行PCI手术治疗的老年AMI患者病史资料,根据预后情况分为预后不良组(30例)和预后良好组(153例)。采用单因素分析和多因素Logistic回归分析影响患者预后的因素。结果单因素分析结果显示,影响预后的因素包括女性(χ~2=5.426,P=0.034)、年龄(χ~2=4.318,P=0.046)、吸烟史(χ~2=4.654,P=0.045)、糖尿病(χ~2=4.631,P=0.047)、高血压(χ~2=8.236,P=0.004)、血清肌酐(χ~2=4.478,P=0.044)和心肌梗死面积≥2支(χ~2=12.873,P=0.001)。多因素分析结果显示,年龄大(OR=1.214)、高血压病史(OR=1.241)、糖尿病史(OR=1.511)、高血清肌酐(OR=1.291)及心肌梗死面积大(OR=1.429)可使患者预后不良的危险性增加。结论高龄、有糖尿病史、高血压史、高血清肌酐和心肌梗死面积≥2支均会增加预后不良的发生风险。
OBJECTIVE Acute myocardial infarction(AMI)is often treated by emergent percutaneous coronary intervention(PCI).The curative effect is remarkable.However,elderly patients are prone to various cardiac events after PCI.This study is to analyze the related factors of short-term prognosis after PCI in elderly patients with AMI.METHODS A total of 183 patients with AMI treated by PCI in Fengcheng Center Hospital were selected from June 1,2015 to August 31,2017.With retrospective analysis of the patient’s medical history,according to the prognosis,all patients were divided into poor prognosis group(30cases)and good prognosis group(153cases).Single factor and multiple factors were used to analyze the prognostic factors.RESULTS Single factor analysis revealed that female,old age,smoking history,diabetes mellitus,hypertension,high SCr and myocardium infarct size≥2branches were the single risk factors for the prognosis of AMI.Multivariate analysis showed that age(OR=1.214),hypertension(OR=1.241),diabetes mellitus(OR=1.511),high SCr(OR=1.291)and myocardium infarct size(OR=1.429)were independent risk factors of poor prognosis and positively correlated with poor prognosis.The higher the age,diabetes,hypertension,SCr and myocardium infarct size were,the higher the risk of poor prognosis was.CONCLUSIONS Hypertension,age,diabetes mellitus,high SCr and myocardium infarct size are independent risk factors for poor prognosis of elderly patients with AMI after PCI.Advanced age,diabetes mellitus,hypertension,high SCr and myocardial infarction size≥2branches all increase the risk of poor prognosis.Active intervention should be taken in clinical practice to improve the prognosis of elderly patients with AMI.
作者
秦志超
高秀娟
QIN Zhi-chao;GAO Xiu-juan(Department of Cardiology,Fengcheng Center Hospital,Fengcheng 118100,P.R.China)
出处
《社区医学杂志》
2018年第19期1447-1450,共4页
Journal Of Community Medicine
关键词
急性心肌梗死
老年
经皮冠状动脉介入术
预后
acute myocardial infarction
old age
percutaneous coronary intervention
prognosis
