临床心血管病杂志
臨床心血管病雜誌
림상심혈관병잡지
JOURNAL OF CLINICAL CARDIOLOGY
2010年
2期
127-129
,共3页
心肌梗死%肾功能恶化%发生率%预后
心肌梗死%腎功能噁化%髮生率%預後
심기경사%신공능악화%발생솔%예후
myocardial infarction%worsening renal function%prevalence%prognosis
目的:评估急性心肌梗死(AMI)患者肾功能恶化的发生率和预后价值.方法:入选了267例AMI患者,平均年龄67.4岁.AMI患者住院第1、2、3天各检测1次血浆肌酐(Cr)值,以后每3 d检测1次,直至第15天或出院.以Cr值较入院升高≥ 44.2 μmol/L判断肾功能恶化,计算其发生率,采用logistic 回归分析筛选AMI患者住院期间死亡的危险因素.结果:267例中32例(12.0%)住院期间发生了肾功能恶化.发生肾功能恶化的AMI患者年龄较大,陈旧性心肌梗死患病率高,Killip分级较高,入院时尿素氮值、Cr值较高,GFR估算值较低.用logistic 回归分析筛选出肾功能不全、肾功能恶化是AMI患者住院期间死亡的危险因素.发生肾功能恶化的AMI患者死亡风险增加至4.287倍(95%CI为2.117~11.282,P<0.01).结论:AMI患者住院期间肾功能恶化发生率为12.0%,是其预后的预测因子.
目的:評估急性心肌梗死(AMI)患者腎功能噁化的髮生率和預後價值.方法:入選瞭267例AMI患者,平均年齡67.4歲.AMI患者住院第1、2、3天各檢測1次血漿肌酐(Cr)值,以後每3 d檢測1次,直至第15天或齣院.以Cr值較入院升高≥ 44.2 μmol/L判斷腎功能噁化,計算其髮生率,採用logistic 迴歸分析篩選AMI患者住院期間死亡的危險因素.結果:267例中32例(12.0%)住院期間髮生瞭腎功能噁化.髮生腎功能噁化的AMI患者年齡較大,陳舊性心肌梗死患病率高,Killip分級較高,入院時尿素氮值、Cr值較高,GFR估算值較低.用logistic 迴歸分析篩選齣腎功能不全、腎功能噁化是AMI患者住院期間死亡的危險因素.髮生腎功能噁化的AMI患者死亡風險增加至4.287倍(95%CI為2.117~11.282,P<0.01).結論:AMI患者住院期間腎功能噁化髮生率為12.0%,是其預後的預測因子.
목적:평고급성심기경사(AMI)환자신공능악화적발생솔화예후개치.방법:입선료267례AMI환자,평균년령67.4세.AMI환자주원제1、2、3천각검측1차혈장기항(Cr)치,이후매3 d검측1차,직지제15천혹출원.이Cr치교입원승고≥ 44.2 μmol/L판단신공능악화,계산기발생솔,채용logistic 회귀분석사선AMI환자주원기간사망적위험인소.결과:267례중32례(12.0%)주원기간발생료신공능악화.발생신공능악화적AMI환자년령교대,진구성심기경사환병솔고,Killip분급교고,입원시뇨소담치、Cr치교고,GFR고산치교저.용logistic 회귀분석사선출신공능불전、신공능악화시AMI환자주원기간사망적위험인소.발생신공능악화적AMI환자사망풍험증가지4.287배(95%CI위2.117~11.282,P<0.01).결론:AMI환자주원기간신공능악화발생솔위12.0%,시기예후적예측인자.
Objective:To evaluate the incidence and the prognostic value of worsening renal function in patients with acute myocardial infarction(AMI).Method:It was a prospect study, and a total of 267 patients were enrolled, the mean age of whom was (67±4 )years. Serial measurements of plasma creatinine were made on days1, 2 and 3 of admission, and then every 3 days thereafter until day 15 or hospital discharge. Worsening renal function was defined as an increase in plasma creatinine (Cr)≥ 44.2 μmol/L from the time of hospital admission. The logistic regression analysis was used to screen for the risk factors of the in hospital death. Result:Worsening renal function developed in 32 patients (12.0%). The worsening renal function was associated with aging, previous infarction, Killip class, higher plasma Cr, BUN level on admission and a lower estimated GFR. The risk of the in hospital death in patients with worsening renal function and renal insufficiency was increased to 4.287 times compared with those without worsening renal function.Conclusion:The incidence of worsening renal function occurred in the patients with AMI was 12.0%, and it might be an independent predictor for in-hospital mortality in the group.
