摘要
目的分析急性心肌梗死(AMI)伴肥厚型心肌病(HCM)的临床特征、治疗与转归,探讨其发病机制,为今后临床治疗提供参考。方法收集焦作市第二人民医院及焦作市人民医院2003—2016年收治的AMI患者59 018例,运用多重Logistic回归等对伴或不伴HCM的AMI患者的临床特征、治疗及转归情况进行统计分析。结果59 018例AMI患者,伴HCM 59例(0.1%)。与不伴HCM的AMI患者相比,伴HCM的AMI患者的年龄、女性比例及出现非ST段抬高型心肌梗死(NSTEMI)、房颤、颈动脉疾病的概率均显著增加(P<0.001),而伴有吸烟、血脂异常、已知的冠状动脉疾病、冠状动脉病家族史、既往心肌梗死、既往经皮冠脉介入、既往冠状动脉移植术、糖尿病的概率及采用血管重建技术治疗的比例均显著减少(P<0.001)。伴与不伴HCM的AMI患者的住院病死率比较差异无统计学意义(P=0.590);在ST段抬高型心肌梗死(STEMI)患者中,与不伴HCM患者相比,伴HCM患者的住院病死率显著降低(P=0.003),而在NSTEMI的患者中,伴与不伴HCM患者的住院病死率比较差异无统计学意义(P=0.630)。结论 HCM患者发生AMI的概率较小,且较少接受血管重建技术治疗。与不伴HCM的患者相比,伴有STEMI的HCM患者住院病死率较低。
Objective To investigate the clinical features,treatment,outcomes and pathogenesis of acute myocardial infarction（AMI）accompanied by hypertrophic cardiomyopathy（HCM）,and to provide reference for future clinical treatment.Methods A total of 59 018 AMI patients with or without HCM who were treated in the Department of Cardiology of Jiaozuo Second People’s Hospital and Jiaozuo People’s Hospital from January 1,2003 to December 31,2016 were selected in this study.Clinical features,treatment and outcomes were analyzed using multivariate Logistic regression analysis.Results Among the 59 018 AMI patients,59（0.1%）had HCM.Compared with patients with HCM,the age,female/male ratio and risks of non-ST segment elevation myocardial infarction（NSTEMI）,atrial fibrillation and carotid disease increased,but the proportions of patients with smoking,dyslipidemia,coronary artery disease（CAD）,family history of CAD,previous myocardial infarction or diabetes and patients previously receiving percutaneous coronary intervention,coronary artery bypass grafting or vascular reconstruction decreased in patients without HCM（P〈0.001）.No significant difference was found in the hospital mortality rate between patients with HCM and patients without HCM（P=0.590）.In patients with ST segment elevation myocardial infarction（STEMI）,the hospital mortality rate in patients with HCM was lower than that in patients without HCM（P=0.003）.However,in patients with NSTEMI,the difference in hospital mortality rate was not significant between patients with HCM and patients without HCM（P=0.630）.Conclusion Patients with HCM have a low probability of AMI,and few of them receive vascular reconstruction.In addition,the hospital mortality rate in patients with HCM is lower than that in patients without HCM.
作者
赵晖
ZHAO Hui(st Department of Cardiovascular Medicine Hospital, Jiaozuo 454000, , Jiaozuo Second People＇s China)
出处
《实用临床医学（江西）》
CAS
2018年第3期11-14,共4页
Practical Clinical Medicine
关键词
急性心肌梗死
肥厚型心肌病
住院病死率
血管重建
acute myocardial infarction
hypertrophic cardiomyopathy
hospital mortality
vascular reconstruction
