摘要
目的探讨老年女性急性ST段抬高型心肌梗死(STEMI)患者远期预后的影响。方法入选我院住院明确诊断为急性STEMI的老年患者287例,按性别分为男性组190例,女性组97例。比较2组患者的临床特点、住院期间及远期主要不良心脑血管事件(MACCE)。结果与男性组比较,女性组平均年龄、高血压、LDL-C、空腹血糖水平明显升高,吸烟、血肌酐、血管病变支数比例显著降低(P<0.05,P<0.01)。2组远期MACCE发生率比较无显著差异(23.4%vs 18.6%,P=0.639)。Cox回归分析显示,高血压(HR=1.954,95%CI:1.058~3.608,P=0.032)、Killip分级(HR=2.017,95%CI:1.454~2.798,P=0.000)、术后TIMI分级(HR=0.552,95%CI:0.422~0.723,P=0.000)及急诊PCI(HR=0.240,95%CI:0.112~0.513,P=0.000)是老年STEMI患者远期MACCE的独立预测因素。结论老年STEMI患者近、远期预后无性别差异,提示性别可能不是老年STEMI患者远期预后的独立预测因素,而高血压、Killip分级、术后TIMI分级及急诊PCI能独立预测老年STEMI患者远期转归。
Objective To study the long-term outcome in elderly female acute ST-segment elevation myocardial infarction （STEMI） patients. Methods Two hundred and eighty-seven acute STEMI patients admitted to our hospital from January 2009 to December 2015 were divided into male group （n = 190） and female group （n = 97）. Their clinical characteristics, inhospital and long-t erm MACCE were compared. Results The age was older, the incidence of hypertension and serum lev- els of LDL-C and fasting blood glucose were significantly higher,the history of smoking was sig- nificantly shorter,the serum creatinine level was significantly lower and the number of lesioned blood vessels was significantly smaller in female group than in male group （P〈0.05 ,P〈0.01）. No significant difference was found in incidence of long-term MACCE between the two groups （23.4% vs 18.6% ,P=0. 639）. Multivariate COX regression analysis showed that hypertension, Killip classification, postoperative TIMI classification, primary PCI were the independent risk fac- tors for long-term MACCE in female acute STEMI patients （HR= 1. 954,95 %CI. 1. 058--3. 608, P=0.032;HR=2.017,95%CI：1.454--2.798,P=0.000;HR=0.552,95%CI：0.422--0.723, P=0. 000;HR：0. 240,95%CI：0. 112--0. 513,P：0. 000）. Conclusion The short-term and long- term outcomes are not different in both elderly male and female acute STEMI patients,indicating that sex is not an independent risk factor for long-term outcomes in acute STEMI patients. How- ever, hypertension,Killip classification, postoperative TIMI classification, primary PCI are the in- dependent predictors for the long-term outcome in elderly acute STEMI patients.
出处
《中华老年心脑血管病杂志》
CAS
2017年第10期1029-1032,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(81470491)
关键词
心肌梗死
心力衰竭
休克
心源性
卒中
高血压
myocardial infarction
heart failure
shock, cardiogenic
stroke
hypertension
