中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2013年
6期
639-640
,共2页
慢性阻塞性肺病%急性心肌梗死%近期预后
慢性阻塞性肺病%急性心肌梗死%近期預後
만성조새성폐병%급성심기경사%근기예후
Chronic obstructive pulmonary disease%Acute myocardial infarction%Short-term prognosis
目的：探讨合并慢性阻塞性肺病（COPD）对急性心肌梗死（AMI）患者近期预后的影响。方法纳入2006年6月~2012年10月广西医科大学附属玉林市第一人民医院AMI患者92例，其中59例患者合并COPD归入AMI+COPD组，其余33例不合并COPD的患者归入AMI组，所有患者均行介入治疗处理罪犯血管。比较入组时两组患者AMI部位和罪犯血管支数以及左室收缩功能[包括左室射血分数（LVEF）和左室舒张末内径（LVEDD）]，同时对所有患者进行3个月随访，观察两组不良事件（包括肺部感染、心律失常、心力衰竭、心源性休克、呼吸衰竭和死亡）的发生率。结果两组不同心肌梗死部位所占比例以及罪犯血管支数无统计学差异（P＞0.05）；与AMI组相比，AMI+COPD组LVEDD值更高[（59.6±6.4） mmvs.（42.8±3.7）mm]，LVEF水平更低[（46.16±8.3）%vs.（59.25±7.2）%]，差异均有统计学意义（P＜0.05）；同时AMI+COPD发生肺部感染（33.90%vs.12.12%）、心律失常（39.98%vs.27.27%）、心力衰竭（15.25%vs.6.06）、呼吸衰竭（22.03%vs.9.09%）、心源性休克（10.17%vs.3.03%）、死亡（8.47%vs.3.03%）的几率均高于AMI组，差异有统计学意义（P＜0.05）。结论 COPD会进一步导致AMI患者心功能恶化，使其近期预后更差。
目的：探討閤併慢性阻塞性肺病（COPD）對急性心肌梗死（AMI）患者近期預後的影響。方法納入2006年6月~2012年10月廣西醫科大學附屬玉林市第一人民醫院AMI患者92例，其中59例患者閤併COPD歸入AMI+COPD組，其餘33例不閤併COPD的患者歸入AMI組，所有患者均行介入治療處理罪犯血管。比較入組時兩組患者AMI部位和罪犯血管支數以及左室收縮功能[包括左室射血分數（LVEF）和左室舒張末內徑（LVEDD）]，同時對所有患者進行3箇月隨訪，觀察兩組不良事件（包括肺部感染、心律失常、心力衰竭、心源性休剋、呼吸衰竭和死亡）的髮生率。結果兩組不同心肌梗死部位所佔比例以及罪犯血管支數無統計學差異（P＞0.05）；與AMI組相比，AMI+COPD組LVEDD值更高[（59.6±6.4） mmvs.（42.8±3.7）mm]，LVEF水平更低[（46.16±8.3）%vs.（59.25±7.2）%]，差異均有統計學意義（P＜0.05）；同時AMI+COPD髮生肺部感染（33.90%vs.12.12%）、心律失常（39.98%vs.27.27%）、心力衰竭（15.25%vs.6.06）、呼吸衰竭（22.03%vs.9.09%）、心源性休剋（10.17%vs.3.03%）、死亡（8.47%vs.3.03%）的幾率均高于AMI組，差異有統計學意義（P＜0.05）。結論 COPD會進一步導緻AMI患者心功能噁化，使其近期預後更差。
목적：탐토합병만성조새성폐병（COPD）대급성심기경사（AMI）환자근기예후적영향。방법납입2006년6월~2012년10월엄서의과대학부속옥림시제일인민의원AMI환자92례，기중59례환자합병COPD귀입AMI+COPD조，기여33례불합병COPD적환자귀입AMI조，소유환자균행개입치료처리죄범혈관。비교입조시량조환자AMI부위화죄범혈관지수이급좌실수축공능[포괄좌실사혈분수（LVEF）화좌실서장말내경（LVEDD）]，동시대소유환자진행3개월수방，관찰량조불량사건（포괄폐부감염、심률실상、심력쇠갈、심원성휴극、호흡쇠갈화사망）적발생솔。결과량조불동심기경사부위소점비례이급죄범혈관지수무통계학차이（P＞0.05）；여AMI조상비，AMI+COPD조LVEDD치경고[（59.6±6.4） mmvs.（42.8±3.7）mm]，LVEF수평경저[（46.16±8.3）%vs.（59.25±7.2）%]，차이균유통계학의의（P＜0.05）；동시AMI+COPD발생폐부감염（33.90%vs.12.12%）、심률실상（39.98%vs.27.27%）、심력쇠갈（15.25%vs.6.06）、호흡쇠갈（22.03%vs.9.09%）、심원성휴극（10.17%vs.3.03%）、사망（8.47%vs.3.03%）적궤솔균고우AMI조，차이유통계학의의（P＜0.05）。결론 COPD회진일보도치AMI환자심공능악화，사기근기예후경차。
Objective To investigate the influence of complicating chronic obstructive pulmonary disease (COPD) on short-term prognosis in the patients with acute myocardial infarction (AMI).Methods The patients (n=92) were chosen from First People’s Hosptal of Yulin City affiliated to Guangxi Medical University from Jun. 2006 to Oct. 2012, and among them 59 with complicating COPD were included into AMI+COPD group and other 33 without COPD were included into AMI group. All patients were given intervention treatment for treating culprit vessels. The locations of AMI, count of culprit vessels and left ventricular systolic function (including LVEF and LVEDD) were compared between two groups. All patients were followed up for 3 months and the incidence of major adverse cardiovascular events (MACE) was observed in two groups (including pulmonary infection, arrhythmia, heart failure, cardiac shock, respiratory failure and death).Results There were no differences in proportion of different AMI locations and count of culprit vessels between two groups (P>0.05). LVEDD was higher [(59.6±6.4)mmvs. (42.8±3.7)mm], LVEF was lower [(46.16±8.3)%vs. (59.25±7.2)%] in AMI+COPD group compared with AMI group(P<0.05). In AMI+COPD group, the incidences of pulmonary infection (33.90%vs. 12.12%), arrhythmia (39.98%vs. 27.27%), heart failure (15.25%vs. 6.06), respiratory failure (22.03%vs. 9.09%), cardiogenic shock (10.17%vs. 3.03%) and death (8.47%vs. 3.03%) were all higher than those in AMI group (P<0.05).Conclusion COPD can induce cardiac dysfunction and poorer prognosis in AMI patients.
