肾功能对急性心肌梗死患者院内预后的影响  

The Impact of Renal Function on the In-hospital Prognosis in Patients with Acute Myocardial Infarction

作　　者：李超[1] 胡大一[2] 杨进刚[1] 孙艺红[2] 宋莉[1] 刘书山[1] 张清潭[1] 王冉冉[1] 杜兰芳[1] 赵薇[1] 

机构地区：[1]首都医科大学附属同仁医院心血管中心,北京100730 [2]北京大学人民医院心内科,北京100044

出　　处：《中国医药导刊》2008年第9期1312-1313,共2页Chinese Journal of Medicinal Guide

基　　金：首都紧急医学救援(5分钟)科技工程建设研究项目[京科技发(2005)593]

摘　　要：目的:评估入院肾功能对急性ST段抬高心肌梗死(STEMI)患者院内预后的影响。方法:入选718例STEMI患者,分为肾功能正常或轻度肾功能不全组(A组)和中重度肾功能不全组(B组),比较两组的临床特点和院内预后。结果:133例STEMI患者存在中重度肾功能不全。与A组相比,B组患者年龄大、女性较多、合并高血压、糖尿病、冠心病、心力衰竭病史多;B组的患者住院期间新出现的心力衰竭和恶性心律失常发生率明显增加,院内死亡率亦显著增高。多因素Logistic回归分析显示,中重度肾功能不全是SrTEMI患者院内死亡的独立危险因素。结论:肾功能不全患者住院期间发生心力衰竭、恶性心律失常增加,院内死亡率增高,中重度肾功能不全是院内死亡的独立危险因素。Objective： To evaluate the outcomes in patients suffering from ST-elevation acute myocardial infarction （STEMI） combined with renal disfunction. Methods：We enrolled 718 patients suffering from STEMI.The patients were divided into the following 2 groups, 585 patients with normal or minimally renal function （Group A） and 133 patients with moderate or severe renal disfunction （Group B）.Clinical variables and outcomes during hospitalization were available in all the patients Results：A Moderate or severe renal disfunction were present in 133 patients of the 718 patients. Compared with patients in group A, patients in group B were older, more likely to be women, and more likely to have hypertension, diabetes mellitns, coronary heart disease and heart failure and to present with new heart failure and malignant arrhythmia. Mortality was markedly increased in group B. After adjustment for other confounding factors, Moderate or severe renal disfunction was independent risk factors for in-hospital mortality. Conclusions：The in-hospital mortality rate and cardiovascular events rates were higher in STEMI patients with moderate or severe renal disfunction than those with normal or minimally impaired renal disfunction. Moderate or severe renal disfunction was an independent risk factor for in-hospital mortality in patients with STEMI.

关 键 词：急性心肌梗死 肾功能不全 院内死亡率 

分 类 号：R542.22[医药卫生—心血管疾病]