中华老年心脑血管病杂志
中華老年心腦血管病雜誌
중화노년심뇌혈관병잡지
CHINESE JOURNAL OF GERIATRIC CARDIOVASCULAR AND CEREBROVASCULAR DISEASES
2014年
10期
1024-1027
,共4页
心肌梗死%心肌缺血%冠状血管造影术%危险因素
心肌梗死%心肌缺血%冠狀血管造影術%危險因素
심기경사%심기결혈%관상혈관조영술%위험인소
myocardial infarction%myocardial ischemia%coronary angiography%risk factors
目的：评价女性与男性急性心肌梗死（AMI）患者的临床特点及预后。方法连续入选AMI患者284例，男216例，女68例，比较女性与男性患者临床特点、合并症、PCI及院内预后的差异，随访3个月主要不良心血管事件（M ACE），评价影响患者死亡及 M ACE的危险因素。结果与男性比较，女性患者年龄偏大、入院时心率偏快、TIMI分级及GRACE评分明显升高（P＜0．05，P＜0．01）。女性冠状动脉造影比例明显降低（30．9％ vs 48．6％， P＝0．012）；院内死亡有增高趋势，但差异无统计学意义（17．6％ vs 9．3％，P＝0．077），3个月MACE发生率高于男性（27.9％ vs 15．7％，P＝0．032）。多因素logistic回归分析显示，年龄（OR＝1．078，95％ CI：1．035～1．123，P＝0．000）和Killip分级（OR＝1．901，95％ CI：1．373～2．633，P＝0．000）是院内死亡的独立危险因素；年龄（OR＝1.040，95％ C I：1．008～1．074，P＝0．015）、Killip分级（OR＝1．543，95％ C I：1．170～2．034，P＝0．002）是3个月MACE的独立危险因素；PCI（OR＝0．090，95％ CI：0．026～0．306，P＝0．000）是3个月MACE的保护因素。结论女性AMI患者年龄偏大、心功能差、危险程度高，接受 PCI比例低，但性别本身并非预测院内死亡及3个月随访M ACE的独立预测因素。
目的：評價女性與男性急性心肌梗死（AMI）患者的臨床特點及預後。方法連續入選AMI患者284例，男216例，女68例，比較女性與男性患者臨床特點、閤併癥、PCI及院內預後的差異，隨訪3箇月主要不良心血管事件（M ACE），評價影響患者死亡及 M ACE的危險因素。結果與男性比較，女性患者年齡偏大、入院時心率偏快、TIMI分級及GRACE評分明顯升高（P＜0．05，P＜0．01）。女性冠狀動脈造影比例明顯降低（30．9％ vs 48．6％， P＝0．012）；院內死亡有增高趨勢，但差異無統計學意義（17．6％ vs 9．3％，P＝0．077），3箇月MACE髮生率高于男性（27.9％ vs 15．7％，P＝0．032）。多因素logistic迴歸分析顯示，年齡（OR＝1．078，95％ CI：1．035～1．123，P＝0．000）和Killip分級（OR＝1．901，95％ CI：1．373～2．633，P＝0．000）是院內死亡的獨立危險因素；年齡（OR＝1.040，95％ C I：1．008～1．074，P＝0．015）、Killip分級（OR＝1．543，95％ C I：1．170～2．034，P＝0．002）是3箇月MACE的獨立危險因素；PCI（OR＝0．090，95％ CI：0．026～0．306，P＝0．000）是3箇月MACE的保護因素。結論女性AMI患者年齡偏大、心功能差、危險程度高，接受 PCI比例低，但性彆本身併非預測院內死亡及3箇月隨訪M ACE的獨立預測因素。
목적：평개녀성여남성급성심기경사（AMI）환자적림상특점급예후。방법련속입선AMI환자284례，남216례，녀68례，비교녀성여남성환자림상특점、합병증、PCI급원내예후적차이，수방3개월주요불양심혈관사건（M ACE），평개영향환자사망급 M ACE적위험인소。결과여남성비교，녀성환자년령편대、입원시심솔편쾌、TIMI분급급GRACE평분명현승고（P＜0．05，P＜0．01）。녀성관상동맥조영비례명현강저（30．9％ vs 48．6％， P＝0．012）；원내사망유증고추세，단차이무통계학의의（17．6％ vs 9．3％，P＝0．077），3개월MACE발생솔고우남성（27.9％ vs 15．7％，P＝0．032）。다인소logistic회귀분석현시，년령（OR＝1．078，95％ CI：1．035～1．123，P＝0．000）화Killip분급（OR＝1．901，95％ CI：1．373～2．633，P＝0．000）시원내사망적독립위험인소；년령（OR＝1.040，95％ C I：1．008～1．074，P＝0．015）、Killip분급（OR＝1．543，95％ C I：1．170～2．034，P＝0．002）시3개월MACE적독립위험인소；PCI（OR＝0．090，95％ CI：0．026～0．306，P＝0．000）시3개월MACE적보호인소。결론녀성AMI환자년령편대、심공능차、위험정도고，접수 PCI비례저，단성별본신병비예측원내사망급3개월수방M ACE적독립예측인소。
Objective To assess the clinical features of female patients with AMI and their out-comes .Methods Two hundred and eighty-four AMI patients (216 males and 68 females) were in-cluded in this study .Their clinical features ,complications ,PCI and outcomes were comared .The patients were followed up for 3 months ,during which the major adverse cardiac events (MACE) were observed with their mortality and risk factors for MACE assessed .Results The age was ol-der and the heart rate ,TIMI grade ,GRACE score were significantly higher in female patients than in male patients (P<0 .05 ,P<0 .01) .The ratio of female patients who underwent PCI was signif-icantly lower than that of male patients who underwent PCI (30 .9% vs 48 .6% ,P=0 .012) .The in hospital mortality was higher in female patients than in male patients (17 .6% vs 9 .3% ,P=0.077) ,and the incidence of MACE in a 3-month follow-up period was significantly higher in fe-male patients than in male patients (27 .9% vs 15 .7% ,P=0.032) .Multivariate logistic regression analysis showed that age and Killip classification were the independent risk factors for in hospital mortality (OR=1 .078 ,95% CI:1 .035 -1 .123 ,P=0 .000 ;OR= 1 .901 ,95% CI:1 .373 -2 .633 , P=0 .000) and for MACE in a 3-month follow-up period (OR=1 .040 ,95% CI:1 .008 -1 .074 , P=0 .015;OR=1 .543 ,95% CI:1 .170-2 .034 ,P=0 .002) .PCI was a protective factor for MACE in a 3-month follow-up period (OR=0 .090 ,95% CI:0 .026-0 .306 ,P=0 .000) .Conclusion The age of female AMI patients is older and their heart function is poorer with a higher risk of MACE and a less chance for PCI .However ,gender itself is not an independent predictor for in hospital mortality and M ACE in a 3-month follow-up period .
