中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
2期
49-51
,共3页
心肌梗死%临床特点%预后%影响因素
心肌梗死%臨床特點%預後%影響因素
심기경사%림상특점%예후%영향인소
Myocardial infarctio%Clinical character%Prognos%Affecting factors
目的 探讨以急性左心衰竭为主要表现的老年人急性心肌梗死(AMI)的临床特点和预后的主要影响因素.方法 回顾性分析96例以急性左心衰竭为主要表现的AMI老年患者的临床资料,其临床特点和预后影响因素.结果 96例中有72例(75.0%)为无痛性梗死;76例(79.2%)为急性非透壁性梗死,12例并发完全性左束支传导阻滞;超声心动图LVEF<40%的有32例,半年内死亡30例(31.25%).Logistic回归分析表明:高血压(OR=1.157)、严重室性心律失常(OR=4.135),休克(OR=5.256),广泛前壁合并侧壁心梗(OR=1.932)、下壁,后壁,右室心梗(OR=1.853)是预后的危险因素,而急诊介入治疗是保护因素(OR=0.318).结论 以急性左心衰竭为主要表现的AMI病情重,死亡率高,其预后主要受并发症,心律失常、梗死的位置和治疗方法的影响.
目的 探討以急性左心衰竭為主要錶現的老年人急性心肌梗死(AMI)的臨床特點和預後的主要影響因素.方法 迴顧性分析96例以急性左心衰竭為主要錶現的AMI老年患者的臨床資料,其臨床特點和預後影響因素.結果 96例中有72例(75.0%)為無痛性梗死;76例(79.2%)為急性非透壁性梗死,12例併髮完全性左束支傳導阻滯;超聲心動圖LVEF<40%的有32例,半年內死亡30例(31.25%).Logistic迴歸分析錶明:高血壓(OR=1.157)、嚴重室性心律失常(OR=4.135),休剋(OR=5.256),廣汎前壁閤併側壁心梗(OR=1.932)、下壁,後壁,右室心梗(OR=1.853)是預後的危險因素,而急診介入治療是保護因素(OR=0.318).結論 以急性左心衰竭為主要錶現的AMI病情重,死亡率高,其預後主要受併髮癥,心律失常、梗死的位置和治療方法的影響.
목적 탐토이급성좌심쇠갈위주요표현적노년인급성심기경사(AMI)적림상특점화예후적주요영향인소.방법 회고성분석96례이급성좌심쇠갈위주요표현적AMI노년환자적림상자료,기림상특점화예후영향인소.결과 96례중유72례(75.0%)위무통성경사;76례(79.2%)위급성비투벽성경사,12례병발완전성좌속지전도조체;초성심동도LVEF<40%적유32례,반년내사망30례(31.25%).Logistic회귀분석표명:고혈압(OR=1.157)、엄중실성심률실상(OR=4.135),휴극(OR=5.256),엄범전벽합병측벽심경(OR=1.932)、하벽,후벽,우실심경(OR=1.853)시예후적위험인소,이급진개입치료시보호인소(OR=0.318).결론 이급성좌심쇠갈위주요표현적AMI병정중,사망솔고,기예후주요수병발증,심률실상、경사적위치화치료방법적영향.
Objective To explore the clinical characters and the affecting factors of early prognosis in the patients with acute left ventricular failure as the main performance of acute myocardial infarction (AMI). Methods The data collected from 96 cases of the elderly beyond 60 years old with acute left ventricular failure as the main performance of AMI, analyzed the clinical features and the affecting factors of early prognosis. Re-sults Among the surveyed 96 patients, 72 patients (75.0%) were painless miocardial infarction, 76 patients (79. 2%)were Acute non-transmural infarction, 12 patients were complicated by complete left bundle branch block;There were 32 cases of patients with echocardiography LVEF less than 40% ,30 patients (31.25%)died within six months. Multiple logistic regression analysis discovered that hypertension,Serious ventricular arrhyth-mia, Combined extensive anterior wall myocardial infarction, Myocardial infarction at inferior, Posterior wall and The right ventricle were the risk factors for AMI,whose relative risks were 1. 157,4. 135,5. 256,1. 932,1. 853 and 0. 318 respectively. Conclusion The mortality rate of acute left ventricular failure as the main performance of AMI are high. Complications, arrhythmia, the location of myocardial infarction and the treatment are the risk factors influencing the early prognosis and aged patients with AMI.
