缺血性心肌病死亡病因分析  

Ischemic cardiomyopathy deaths:etiological analysis

作　　者：马莉[1] 李晓惠[1] 汤丽[1] 

机构地区：[1]复旦大学附属华山医院宝山分院心内科,上海200431

出　　处：《同济大学学报（医学版）》2009年第4期141-144,共4页Journal of Tongji University(Medical Science)

摘　　要：目的通过对55例缺血性心肌病死亡病例回顾分析,总结其与死亡相关的危险因素。方法对55例缺血性心肌病患者死亡的临床资料及相关检查,进行分析总结。结果死亡患者年龄以80-89岁最多发生。既往有高血压病史者44例。反复心绞痛史者45例,心肌梗死史20例。心衰病程2年者31例。死亡病因：心衰伴呼衰17例;心跳骤停16例。所有病例均有心律失常发生,并发房颤32例;室性心律失常26例。电解质紊乱者38例,低钠血症25例。大多数患者合并低脂血症、低血清总蛋白、低白蛋白血症、肾功能损伤及血清肌钙蛋白增高等。结论缺血性心肌病末期患者,其肺部感染、心律失常、低钠血症、低脂、低白蛋白血症、肌钙蛋白持续增高,左室射血分数降低这些因素均为病情恶化指标,与死亡密切相关。Objective To study the risk factors of ischemic cardiomyopathy deaths by reviewing 55 such cases. Methods Medical records and related examination outcomes of 55 deaths resulted from ischemic cardiomyopathy were retrieved and risk factors were summarized. Results Most deaths happened in patients with advanced age, ranging from 80 to 89. Among them, 44 cases associated with high blood pressure （HBP）, 45 with retro-angina pectoris, 20 with acute myocardial infarction （AMI） and 31 with two-year-course of heart failure. There were 17 patients who died from heart failure complicated with respiratory failure, and 16 died from cardiac arrest. Cardiac arrhythmia occurred in all the cases, in which 32 cases associated with atrial fibrillation, and 26 cases with ventricular arrhythmia （VA）. There were 38 cases of electrolyte disturbances, including 25 cases of hyponatremia. Most patients were found suffering from complications such as hypolipaemia, low total protein, low albumin, impariment of renal function, and cardiac troponin alteration. Conclusion Episodes such as lung infection, arrhythmia, hyponatremia, hypolipaemia, low serum albumin, elevation of cardiac troponin, and decrease of ejection fraction of left ventricle are high risk markers as signs for disease deterioration in senescent patients with late-phase ischemic cardiomyopathy, and closely correlate with death.

关 键 词：缺血性心肌病 死亡 危险因素 

分 类 号：R542.2[医药卫生—心血管疾病]