CAJ | 학술논문

[目的]探讨再发心肌梗死病人(RAMI)的危险因素。[方法]采用回顾性病例对照方法，从2011年6月-2013年6月住院的明确诊断为再发心肌梗死的病人42例为再发性心肌梗死组(RA-MI组)，按照性别相同、年龄±2岁、1：2匹配原则，随机选择同期住院已确诊首发心肌梗死病人作为心肌梗死组，共84例，记录年龄、性别、既往史、家族史、住院情况等指标。[结果]RAMI 组病人年龄、心率、收缩压、舒张压、体质指数、总胆固醇、空腹血糖以及吸烟者比例、Ⅲ度房室传导阻滞者比例均较高，甘油三酯、高敏C反应蛋白、低密度脂蛋白及射血分数较低。高龄、心率、体质指数、高血压、糖尿病以及吸烟是再发性心肌梗死的危险因素，其OR值依次为1.107、1.032、1.030、1.603、1.610和1.227。[结论]首发急性心肌梗死病人，干预高血压，积极治疗高血脂、控制理想血糖水平，同时戒烟酒、控制体重，才能进一步降低心肌再梗死发病率。
[목적]탐토재발심기경사병인(RAMI)적위험인소。[방법]채용회고성병례대조방법，종2011년6월-2013년6월주원적명학진단위재발심기경사적병인42례위재발성심기경사조(RA-MI조)，안조성별상동、년령±2세、1：2필배원칙，수궤선택동기주원이학진수발심기경사병인작위심기경사조，공84례，기록년령、성별、기왕사、가족사、주원정황등지표。[결과]RAMI 조병인년령、심솔、수축압、서장압、체질지수、총담고순、공복혈당이급흡연자비례、Ⅲ도방실전도조체자비례균교고，감유삼지、고민C반응단백、저밀도지단백급사혈분수교저。고령、심솔、체질지수、고혈압、당뇨병이급흡연시재발성심기경사적위험인소，기OR치의차위1.107、1.032、1.030、1.603、1.610화1.227。[결론]수발급성심기경사병인，간예고혈압，적겁치료고혈지、공제이상혈당수평，동시계연주、공제체중，재능진일보강저심기재경사발병솔。
Obj ective:To probe into the risk factors of elderly patients with recurrent myocardial infarction (RMI).Methods:A total of 42 mid-dle age and elderly inpatients in Kailuan general hospital were selected as observation group who were diagnosed as RAMI (aged up 40 years old)from June in 2011 to June in 2013 by using retrospective case con-trol method.According to the principle including same sex,age±2 years and 1:2 matching,a total of 84 cases of first myocardial infarction pa-tients were randomly selected as AMI group who were diagnosed and hospitalized at the same period,then to record age,sex,medical history, family history,hospitalizations and other indicators.Results:In RAMI group,the patients had increasing trend in age,heart rate,SBP,DBP, BMI,TC,FBG and proportion of smokers,proportion of Ⅲ AVB,but TG,hs CRP,LDL and ej ection fraction were lower.The advanced age, heart rate,BMI,hypertension,diabetes and smoking were the risk fac-tors for the RAMI,and the OR value was respectively 1.107,1.107,1. 107,1.603,1.61 and 1.227.Conclusion:For first acute myocardial in-farction patients,only with intervention of hypertension,aggressive treatment of high cholesterol,control of blood sugar levels,quiting smoking and alcohol,and weight control,it can further reduce the inci-dence of recurrent myocardial infarction.