摘要
【目的】分析急性心肌梗死(AMI)患者发生院内死亡事件的危险因素。【方法】回顾性分析2012年5月至2016年12月本院收治的235例AMI患者的临床资料,根据患者在院转归分为观察组(n=51,院内病死者)和对照组(n=184,院内存活者)。通过电子病例系统收集入院时研究对象临床特征、实验室检查(肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、肌酐(Cr)、左心室射血分数(LVEF)以及再灌注治疗情况。采用二元logistic回归分析AMI患者发生在院期间死亡事件的危险因素。【结果】观察组患者年龄、cTnI水平及胸痛时间高于对照组,而再灌注治疗率(再灌注为AMI患者确诊后行急诊PCI或择期PCI或溶栓治疗)及LVEF显著低于对照组,差异有统计学意义(P<0.05)。logistic回归分析显示,cTnI、年龄、LVEF及未行再灌注治疗与AMI患者在院期间发生死亡事件相关(P<0.05)。cTnI预测AMI患者在院期间发生死亡事件的价值最高,其ROC曲线下面积(AUC)(95%CI)高达0.89(0.84~0.94),显著高于其他危险因素(P<0.05)。【结论】cTnI水平高、年龄、心功能、未行再灌注治疗是AMI发生院内死亡的危险因素。
【Objective】To analyze the risk factors for in-hospital mortality in acute myocardial infarction patients.【Methods】The clinical data of 235 AMI patients admitted to our hospital from May 2012 to December 2016 were analyzed retrospectively.According to the patients'in-hospital outcomes,they were divided into the observation group(n=51,in-hospital death patients)and the control group(n=184,in-hospital survival patients).The clinical characteristics,laboratory tests(CK-MB,cTnI,Cr),LVEF and reperfusion treatment were collected by electronic case system.Binary logistic regression was used to analyze the risk factors of AMI patients'death in hospital.【Results】The age,cTnI level and chest pain time of the patients in the observation group were higher than those in the control group,while the reperfusion treatment rate(PCI or selective PCI or thrombolysis after reperfusion for AMI patients)and LVEF were significantly lower than those in the control group(P<0.05).Logistic regression analysis showed that cTnI,age,LVEF and no reperfusion treatment were related to the death events of AMI patients in hospital(P<0.05).cTnI had the highest value in predicting the death events of AMI patients in hospital.The ROC area under curve(AUC)(95%CI)was as high as 0.89(0.84~0.94),significantly higher than other risk factors(.0.05).【Conclusions】The high level of cTnI,age,cardiac function and no reperfusion treatment are the risk factors of hospital death in AMI.
作者
马宏恩
王鑫
赵伟
李媛
MA En-hong;WANG Xin;ZHAO Wei(Ninth hospital of xi'an,xi'an 710054)
出处
《医学临床研究》
CAS
2019年第11期2163-2165,共3页
Journal of Clinical Research
关键词
心肌梗死
急性病
住院病人
预后
Myocardial Infarction
Acute Disease
Inpatients
Prognosis
