缺血性心肌病患者临床特征及预后影响因素分析  

Clinical characteristics and influence factors of prognosis in patients with ischemia cardiomyopathy

作　　者：马凌云[1] 冯广智[2] 丁国斌[2] 何世贵[1] Ma Lingyun;Feng Guangzhi;Ding Guobin;He Shigui(Department of Geriatrics,People's Hospital of Taixing City,Jiangsu Province,Taixing 225400,China;不详)

机构地区：[1]泰兴市人民医院老年医学科,泰兴225400 [2]泰兴市人民医院心血管内科,泰兴225400

出　　处：《中国循证心血管医学杂志》2022年第2期214-216,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨缺血性心肌病患者的临床特征及预后影响因素。方法选择2019年2月至2020年2月于泰兴市人民医院收治的100例缺血性心肌病患者进行研究,根据随访情况分为预后不良组(n=19)和预后良好组(n=81)。收集患者临床资料,并分析缺血性心肌病的临床特点及治疗结局,采用多因素Logistic回归模型分析患者预后不良的危险因素。结果患者男女比为55:45,NYHA心功能分级中Ⅱ级27例,Ⅲ级60例,Ⅳ级13例;54例行经皮冠状动脉介入治疗(PCI)。本研究中以急性心肌梗死、心绞痛后继发心力衰竭为起病形式者分别为48例和30例,另有22例患者无典型心肌缺血症状,仅以心力衰竭为首发表现。随访发现患者中预后不良者19例。单因素分析结果显示,两组在性别、吸烟、糖尿病、高脂血症、心率、心房颤动(房颤)、心律失常、支架植入、起搏器植入及左室后壁差异等方面均无统计学意义(P>0.05);在年龄、体质指数(BMI)、频发室早+短阵室速、白蛋白、左房内径、左室舒张末期内径、左室射血分数(LVEF)方面,差异均有统计学意义(P<0.05);多因素非条件Logistic回归结果显示,年龄、BMI、频发室早+短阵室速、白蛋白、左房内径、左室舒张末期内径、LVEF均是缺血性心肌病患者预后不良的独立危险因素(P<0.05)。结论缺血性心肌病患者临床表现多样,应早期发现,及时有效的治疗,以便延缓疾病进展。Objective To discuss the clinical characteristics and influence factors of prognosis in patients with ischemia cardiomyopathy.Methods The patients(n=100)were chosen from People's Hospital of Taixing City from Feb.2019 to Feb.2020,and divided,according to follow-up results,into poor prognosis group(n=19)and good prognosis group(n=81).The clinical materials were collected in 2 groups,and clinical characteristics of ischemia cardiomyopathy and therapeutic outcomes were analyzed.The risk factors of poor prognosis were analyzed by using multi-factor Logistic regression model.Results The ratio of male cases to female cases was 55:45.There were 27 cases of gradeⅡin heart function classification,60 of gradeⅢand 13 of gradeⅣ.There were 54 patients received percutaneous coronary intervention(PCI).There were 48 patients and 30 patients with heart failure secondary to acute myocardial infarction and angina pectoris respectively as onset form,and other 22 patients had no typical symptoms of myocardial ischemia only with heart failure as initial manifestation.Among them,19 patients were found to have poor prognosis during follow-up.The results of single-factor analysis showed that the difference in gender,smoking,diabetes,hyperlipidemia,heart rate,atrial fibrillation,arrhythmia,stent implantation,pacemaker implantation and left ventricular posterior wall had no statistical significance between 2 groups(P>0.05),while the difference in age,body mass index(BMI),frequent premature ventricular contraction(FPVC)+paroxysmal supraventricular tachycardia(PSVT),albumin(ALB),left atrial diameter(LAD),left ventricular end-diastolic inner diameter(LVEDd)and left ventricular ejection fraction(LVEF)had statistical significance between 2 groups(P<0.05).The results of multi-factor Logistic regression analysis showed that age,BMI,FPVC+PSVT,ALB,LAD,LVEDd and LVEF all were independent risk factors of poor prognosis in patients with ischemia cardiomyopathy.Conclusion In patients with ischemic cardiomyopathy,there are various clinical manifes

关 键 词：缺血性心肌病 临床特征 预后 影响因素 

分 类 号：R542.2[医药卫生—心血管疾病]