急性心肌梗死后室壁瘤形成的相关因素分析  

Related Risk Factor Analysis for Ventricular Aneurysm Formation in Patients After Acute Myocardial Infarction

作　　者：白明[1] 庞军[1] 高涵翔[1] 邓爱云[1] 李强[1] 彭瑜[1] 康宏[1] 汪涛[1] 陈长源[1] 王东[1] 张博[1] 王世杰[1] 药素毓[1] 张钲[1] 

机构地区：[1]兰州大学第一医院心内科,甘肃省兰州市730000

出　　处：《中国循环杂志》2015年第10期950-953,共4页Chinese Circulation Journal

摘　　要：目的：探讨急性心肌梗死（心梗）患者室壁瘤形成的危险因素。方法：将我院2012-04至2014-07期间急性心梗行经皮冠状动脉介入治疗术资料完整的288例患者按照是否发生室壁瘤分为室壁瘤组146例和非室壁瘤组142例,从年龄、性别、高血压、高脂血症、糖尿病、吸烟、家族史、心梗史、前壁心梗、心绞痛发作、左主干病变、前降支近段病变、纽约心脏协会（NYHA）心功能Ⅲ/Ⅳ级、胸痛时间≥24 h、≥4个相邻导联ST段抬高等结果方面对室壁瘤形成的危险因素进行回顾性分析。结果：室壁瘤组患者的年龄（OR=1.023,95%CI：1.000-1.046）、吸烟（OR=1.819,95%CI：1.130-2.928）、前壁心梗（OR=9.162,95%CI：4.657-18.028）、≥4个相邻导联ST段抬高（OR=6.571,95%CI：2.426-17.798）发生比例显著高于非室壁瘤组（P均〈0.05）,而室壁瘤组心绞痛发作（OR=0.557,95%CI：0.335-0.927）低于非室壁瘤组。经多因素Logistic回归分析,并调整年龄、性别、高血压、糖尿病和心绞痛发作影响后,结果显示吸烟（回归系数：0.833,OR=2.301,95%CI：1.283-4.125）,前壁心梗（回归系数：1.799,OR=6.041,95%CI：2.831-12.894）与室壁瘤事件呈正相关。结论：吸烟与前壁急性心梗是急性心梗后室壁瘤发生的危险因素,且前壁急性心梗是室壁瘤发生的强相关因素。Objective： To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction （AMI）. Methods： Our research included 2 groups of AMI patients who received percutaneous coronary intervention （PCI） in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group, n=146 and Control group, n=142, in which the AMI patients without ventricular aneurysm formation. The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age, gender, hypertension, hyperlipidaemia, diabetes, smoking, family history, MI history, anterior myocardial wall infarction, angina pectoris, left main （LM） disease, the lesion at proximal left anterior descending （LAD） artery, NYHA classification III/IV, chest pain time 〉 24 hours and ST-segment elevation 〉 4 adjacent leads in ECG. Results： Compared with Control group, the patients in Ventricular aneurysm group had the elder age （OR=1.023, 95% CI 1.000-1.046）, higher incidence rates of smoking （OR=1.819, 95% CI 1.130-2.928） and anterior MI （OR=9.162, 95% CI 4.657-18.028）, more patients with _〉 4 adjacent ST-segment elevation （OR=6.571, 95% CI 2.426-17.798）, while less patients

关 键 词：急性心肌梗死 室壁瘤 危险因素 

分 类 号：R541[医药卫生—心血管疾病]