慢性肾衰竭合并急性心肌梗死患者临床特点和住院期转归的相关因素  

Clinical characteristics and related factors of hospitalization outcomes in patients with chronic renal failure associated with acute myocardial infarction

作　　者：程欢[1] 陈星华[1] 付豆 丁国华[1] 

机构地区：[1]武汉大学人民医院肾内科,湖北武汉430060

出　　处：《中国医药导报》2017年第9期66-69,共4页China Medical Herald

基　　金：国家自然科学基金青年基金项目(81500516)

摘　　要：目的探讨慢性肾衰竭合并急性心肌梗死(AMI)患者的临床特征和住院转归及其相关因素。方法回顾性分析2013年5月~2016年5月武汉大学人民医院肾内科慢性肾衰竭合并AMI 108例患者临床资料,按住院期转归分为不良转归组和对照组,对两组患者的临床特征进行比较。结果 108例患者住院期不良转归发生率为33.3%。AMI确诊2 d内不良转归发生率为20.3%,其中院内发病患者不良转归发生率高于院外发病患者(P<0.05)。两组临床资料单因素分析:不良转归组女性、慢性肾脏病(CKD)5期、院内发病、透析龄>1年、合并消化道出血、白细胞计数(WBC)、中性粒细胞计数(NEU)水平高于对照组,血红蛋白(Hb)水平低于对照组(P<0.05)。多因素Logistic回归分析:年龄、透析龄>1年、合并消化道出血是慢性肾衰竭合并AMI患者住院期不良转归的独立危险因素(P<0.05)。结论慢性肾衰竭合并AMI患者住院期不良转归事件发生率高,高龄、透析龄>1年、合并消化道出血提示预后不好。Objective To investigate clinical characteristics and relevant factors of hospitalization outcomes in patients with chronic renal failure associated with acute myocardial infarction （AMI）. Methods The clinical data of 108 patients with chronic renal failure associated with AMI in Department of Nephrology, Renmin Hospital of Wuhan University were analyzed retrospectively from May 2013 to May 2016. According to hospitalization outcomes, the patients were di- vided into two groups： adverse outcomes group and control group. Clinical characteristics were compared between the two groups. Results The incidence of adverse outcomes of 108 patients was 33.3%. The incidence of adverse outcomes was 20.3% within 2 days after AMI diagnosis, and the incidence in patients with nosocomial onset was higher than that in patients with extramural onset （P 〈 0.05）. Univariate analysis showed that adverse outcomes group had higher rates or levels of female, stage 5 CKD, nosocomial onset, dialysis age greater than 1 year, gastrointestinal hemorrhage, white blood cell count, neutrophil count, and lower 1eye1 of hemoglobin than those of the control group （P 〈 0.05）. Multivari- ate Logistic regression analysis showed that the independent risk factors of adverse outcomes in patients with chronic renal failure associated with AMI were age, dialysis age greater than 1 year, gastrointestinal hemorrhage （P 〈 0.05）. Conclusion Patients with chronic renal failure associated with AMI have high incidence of adverse outcomes. Age, dialysis age greater than 1 year, combined with gastrointestinal hemorrhage prompt a poor prognosis.

关 键 词：慢性肾衰竭 急性心肌梗死 转归 

分 类 号：R692.502[医药卫生—泌尿科学]