老年急性心肌梗死患者住院死亡危险因素分析  

Risk factors for in-hospital mortality among elderly patients with acute myocardial infarction

作　　者：裴志勇[1] 毕磊[1] 曹丹阳[1] 陈艳梅[1] 施冰[1] 冬兰[1] 

机构地区：[1]北京军区总医院干部病房一科,北京100700

出　　处：《中国临床保健杂志》2014年第3期229-231,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨入院时影响老年急性心肌梗死(AMI)患者住院病死率的危险因素。方法选取因AMI收住的356例老年患者为研究对象。分析病死组(45例)与存活组(311例)患者的临床特征、实验室化验指标、心血管并发症(心源性休克、心力衰竭、室速/室颤),以Logistic多因素逐步回归分析影响老年AMI患者住院病死率的相关因素。结果单因素分析显示:年龄、糖尿病史、陈旧性MI病史、脑卒中病史、肾功能不全、贫血、首发症状呼吸困难、并发心源性休克、心力衰竭、室速/室颤,入院时血清肌酐升高、肾小球滤过率(eGFR)及血红蛋白减低、肌酸激酶及其同工酶峰值水平与老年AMI患者住院病死率相关(均P<0.05)。多因素分析显示:年龄、糖尿病史、陈旧性MI病史,并发心源性休克、心力衰竭、室速/室颤,入院时eGFR水平是影响老年AMI患者住院病死率的独立危险因素(均P<0.05)。结论年龄、糖尿病及陈旧性MI病史、发生心血管并发症、入院时eGFR水平是影响老年AMI患者住院病死率的独立危险因素。Objective To investigate the factors associated with in-hospital mortality among elderly patients with acute myocardial infarction （AMI）.Methods 356 elderly patients with AMI were admitted from Jan,2001 to Jan,2013.The patients were divided into two groups：the death group（n=45）and the survival group（n=311）.The clinical characteristics,laboratory tests and cardiovascular complications （cardiogenic shock,heart failure,ventricular tachycardia or fibrillation）were analyzed.The multiple factors analysis were carried out through Logistic regression. Results The age,the history of diabetes,myocardial infarction and stroke,impaired renal function,anemia,incipient dyspnea,cardiogenic shock,heart failure and ventricular tachycardia or fibrillation,the increased level of serum creatinine,and the decreased levels of glomerular filtration rate（GFR）and haematoglobin on admission,and the levels of creatine kinase and its isoenzyme were significantly associated with the in-hospital mortality （P 〈0.05）.Multivariate logistic regression analysis showed that the major risk factors of the in-hospital mortality were age,history of diabetes and myocardial infarction,cardiogenic shock,heart failure,ventricular tachycardia,fibrillation,and the level of GRF on admission （P 〈0.05）.Conclusion Age,the history of diabetes and myocardial infarction,cardiovascular complications,and the level of GFR on admission are the independent predictors of in-hospital mortality among elderly patients with AMI.

关 键 词：心肌梗死 死亡原因 危险因素 老年人 

分 类 号：R542.22[医药卫生—心血管疾病]