急性ST段抬高型心肌梗死患者短期预后影响因素.doc

急性ST段抬高型心肌梗死患者短期预后影响因素 　　摘要：目的 分析急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）短期预后的影响因素。方法 回顾性分析我院2012年6月～2016年6月收治的急性STEMI患者348例，按住院期间有无发生主要不良心脏事件（major adverse cardiac event，MACE）分为事件组（106例）和对照组（242例），通过对比两组的基本情况、实验室检查、影像学检查及治疗方法，分析影响两组间预后因素的差异。结果 通过对比显示：初次心率≥76次/min、尿素氮≥5.3mmol/L、C反应蛋白≥7.35mg/L均是发生MACE的危险因素，舒张压≥75mmHg、PCI治疗是保护因素。结论 心率快、肾功能不全、炎症均是急性STEMI患者发生MACE的独立危险因素。维持舒张压、PCI治疗有益于AMI患者的短期预后，而与既往高血压病史相关性不明显 关键词：急性ST段抬高型心肌梗死；影响因素；主要不良心脏事件 Abstract：Objective To investigate the short-term prognosis of patients with acute ST-segment elevation myocardial infarction （STEMI）.Methods The data of 348 in-hospital patients with acute STEMI were collected from the database of our hospital during June 2012-June 2016.According to whether or not major adverse cardiac event（MACE）occurred during hospitalization the patients were divided into incident group（106）and control group（242），by comparing the basic situation，two groups of laboratory examination，imaging examination and treatment methods，analysis of the impact of differences in prognostic factors between the two groups.Results By comparing the two groups， analysis showed that initial heart rate≥76 times/min，blood urea nitrogen≥5.3mmol/L，C-reactive protein≥7.35mg/L were the risk factors and diastolic blood pressure≥75mmHg，PCI were the protective factors of MACE.Conclusion The rapid heart rate，renal insufficiency，inflammation were the independent risk factors of MACE with STEMI patients.To maintain high diastolic blood pressure and PCI were good for the short-term prognosis of patients with acute STEMI.The correlation of MACE and hypertension history is not obvious. Key words：ST segment elevation acute myocardial infarction；Influencing factors；Major adverse cardiac events 急性心肌梗死（Acute myocardial infarction，AMI）是心?瓤瞥＜?的急危重症，发病率高，且常伴有严重并发症及恶性心律失常。AMI的预后受众多因素的影响，但目前对其仍有争议，本研究旨在明确STEMI预后的影响因素，明确管理内容，抓住临床管理重点 1 资料与方法 1.1一般资料 连续收集我院2012年6月～2016年6月STEMI患者，据纳入排除标准筛选共有病例348例。纳入标准：符合中华医学会心血管病学分会《急性心肌梗死诊