老年冠心病无症状心肌缺血患者预后的相关因素分析  

Prognostic factors for silent myocardial ischemia in old patients with coronary heart disease

作　　者：易仁亮[1] 江亚文[1] 

机构地区：[1]广州军区广州总医院老年病一科,广州市510010

出　　处：《中华老年多器官疾病杂志》2010年第5期436-438,441,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨冠心病无症状心肌缺血（SMI）老年患者相关临床特征和再发心脏事件的关系,评价其对预后的影响。方法随访216例老年冠心病SMI患者2~7（平均5.01）年。记录年龄、性别、高血压、糖尿病、高脂血症、吸烟、心肌梗死病史、室性心律失常、左室肥厚、SMI持续时间、ST段压低程度等临床特征和动态心电图参数,并记录心肌梗死和心源性死亡发生情况。结果共有27例患者出现心肌梗死或心源性死亡,7年累积再发心脏事件率为14.54%。Cox多因素分析表明,年龄、左室肥厚、心肌梗死病史和高脂血症是再发心脏事件的独立危险因素。结论积极消除或减轻上述危险因素,将有助于改善这些患者的预后。Objective To investigate the clinical features of silent myocardial ischemia（SMI） in elderly patients with coronary heart disease（CHD） and the unfavorable prognostic factors for recurrent heart events,such as acute myocardial infarction（AMI） or sudden cardiac death（SCD）.Methods A total of 216 elderly CHD patients with SMI were followed up for 2-7（mean 5.01） years.The clinical features,including age,gender,systemic hypertension,diabetes mellitus,hyperlipidemia,smoking,history of myocardial infarction,complex ventricular arrhythmia attack,left ventricular hypertrophy,frequency and ischemia duration of SMI,and degree of ST segment depression,as well as Holtor′s parameters,were recorded.The occurrence of AMI and SCD were also noted.Results There were 27 patients who sufferred AMI or SCD at the end of follow-up.The accumulative incidence of recurrent heart events was 14.54% during 7-year follow-up.Cox multivariable regression analysis showed that age,left ventricular hypertrophy,history of myocardial infarction,and hyperlipidemia were independent risk factors for recurrent heart events.Conclusion It would be helpful to improve the prognosis of elderly CHD patients with SMI to remove or alleviate these negative prognostic factors.

关 键 词：无症状心肌缺血 冠心病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]