急性ST段抬高型心肌梗死预后危险因素的Logistic回归分析  

Logistic regression analysis of prognostic risk factors for acute ST segment elevation myocardial infarction

作　　者：呙锐锋[1] 赵丹丹[1] GUO Rui-feng ZHAO Dan-dan(Department of Cardiology, Daqing Oilfield General Hospital, Daqing, Hei- longjiang, 163001, China)

机构地区：[1]大庆油田总医院心内科,黑龙江大庆市163001

出　　处：《心血管康复医学杂志》2016年第5期480-483,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：探讨急性ST段抬高型心肌梗死（STEMI）预后的危险因素,以降低患者死亡率。方法：回顾性分析2011年7月~2013年12月收治的142例STEMI患者的临床资料。根据是否死亡,患者被分为死亡组（47例）和存活组（95例）。比较两组STEMI的相关因素,采用多因素Logistic回归分析影响STEMI预后的独立危险因素。结果：与存活组比较,死亡组年龄[（60.6±8.9）岁比（71.5±6.4）岁]显著更大;糖尿病史（26.32%比48.94%）、陈旧性心肌梗死史（11.58%比31.91%）、脑梗死史（14.74%比23.40%）、贫血（32.63%比48.94%）、心源性休克（7.37%比29.79%）、心律失常（9.47%比19.15%）、心力衰竭（14.74%比23.40%）患者比例显著升高;发病至入院时间〈24h比例（83.16%比46.81%）显著减小,P〈0.05或〈0.01。多因素Logistic回归分析显示年龄、糖尿病史、心源性休克、心律失常、心力衰竭和发病至入院时间是影响STEMI预后的独立危险因素（OR=1.792~2.312,P〈0.05或〈0.01）。结论：年龄、糖尿病史、心源性休克、心律失常、心力衰竭和发病至入院时间是急性ST段抬高型心肌梗死患者死亡的主要原因,应对这些因素进行合理的干预,以降低病死率。Objective：To explore prognostic risk factors of acute ST segment elevation myocardial infarction（STEMI）in order to minimize mortality rate.Methods：Clinical data of 142 STEMI patients,who were treated from Jul2011 to Dec 2013,were retrospectively analyzed.According to death or not,patients were divided into death group（n=47）and survival group（n=95）.STEMI related factors were compared between two groups,and multi-factor Logistic regression analysis was used to analyze independent risk factors for STEMI prognosis.Results：Compared with survival group,there were significant rise in age[（60.6±8.9）years vs.（71.5±6.4）years];percentages of diabetes mellitus history（26.32% vs.48.94%）,old myocardial infarction history（11.58% vs.31.91%）,cerebral infarction history（14.74% vs.23.40%）;anemia（32.63% vs.48.94%）,cardiogenic shock（7.37% vs.29.79%）,arrhythmia（9.47% vs.19.15%）,and heart failure（14.74% vs.23.40%）,significant reduction in percentage of onset-to-hospitalization length 24h（83.16% vs.46.81%）in death group,P〈0.05or0.01.Multi-factor Logistic regression analysis indicated that age,diabetes mellitus history,cardiogenic shock,arrhythmia,heart failure and onset-to-hospitalization time were independent risk factors for STEMI prognosis（OR= 1.792~ 2.312,P〈0.05or0.01）.Conclusion：Age,diabetes mellitus history,carcinogenic shock,arrhythmia,heart failure and onset-to-hospitalization time are main causes for death in patients with acute ST segment elevation myocardial infarction.Reasonable interventions should be performed on these factors in order to reduce mortality rate.

关 键 词：心肌梗死 危险因素 预后 

分 类 号：R542.220.9[医药卫生—心血管疾病]