青年心肌梗死患者预后的影响因素  

Influencing factors of prognosis of young patients with myocardial infarction

作　　者：董宁超[1] 王文斌[1] 程国杰[1] DONG Ningchao;WANG Wenbin;CHENG Guojie(Department of Cardiology,Beijing Daxing District People’s Hospital,Beijing102600,China)

机构地区：[1]北京市大兴区人民医院心内科,北京102600

出　　处：《中国医药导报》2023年第20期86-90,共5页China Medical Herald

基　　金：首都卫生发展科研专项项目(首发2020-3-7122)。

摘　　要：目的 探讨青年心肌梗死患者预后的影响因素。方法 回顾性分析2020年1月至2022年5月北京市大兴区人民医院接受治疗的360例青年心肌梗死患者为研究对象,所有患者均随访至2022年11月,依据是否发生心源性休克、心力衰竭、心律失常、梗死后心绞痛、死亡将其分为预后不良组(116例)和预后良好组(244例)。比较两组各项临床资料,进一步采用logistic回归模型分析青年心肌梗死患者预后的影响因素。结果 预后不良组的心率、饮酒占比、Killip分级为Ⅳ级占比、C反应蛋白、红细胞体积分布宽度、肌酸激酶同工酶杂化型、纤维蛋白原、心肌肌钙蛋白、N端脑钠肽前体水平均高于预后良好组,射血分数低于预后良好组,差异有统计学意义(P<0.05)。多因素分析结果显示,Killip分级(OR=1.672,95%CI:1.123~2.489)、红细胞体积分布宽度(OR=2.319,95%CI:1.500~3.586)、纤维蛋白原(OR=3.422,95%CI:1.123~2.489)为青年心肌梗死患者预后不良的影响因素(P<0.05)。结论 Killip分级、红细胞体积分布宽度、纤维蛋白原为青年心肌梗死患者预后不良的危险因素,临床治疗中应对这些指标异常的患者加强监测。Objective To explore the influencing factors of prognosis of young patients with myocardial infarction.Methods A retrospective analysis was performed on 360 young patients with myocardial infarction who received treatment in Beijing Daxing District People’s Hospital from January 2020 to May 2022.All patients were followed up until November 2022.According to the occurrence of cardiogenic shock,heart failure,arrhythmia,angina pectoris after infarction,and death,the patients were divided into poor prognosis group(116 cases)and good prognosis group(244 cases).The clinical data of the two groups were compared.Logistic regression model was used to analyze the influnencing factors of prognosis of young patients with myocardial infarction.Results The heart rate,drinking proportion,Killip gradeⅣproportion,C-reactive protein,red cell volume distribution width,creatine kinase isozyme hybrid type,fibrinogen,myocardial troponin,and N-terminal brain natriuretic peptide precursor levels in the poor prognosis group were higher than those in the good prognosis group,and ejection fraction was lower than that in the good prognosis group,the differences were statistically significant(P<0.05).The results of multivariate analysis showed that Killip grading(OR=1.672,95%CI:1.123-2.489),red cell volume distribution width(OR=2.319,95%CI:1.500-3.586),fibrinogen(OR=3.422,95%CI:1.123-2.489)were the influencing factors of poor prognosis in young patients with myocardial infarction(P<0.05).Conclusion Killip grading,red blood cell volume distribution width,and fibrinogen are risk factors for poor prognosis in young patients with myocardial infarction,and patients with abnormal indexes should be closely monitored in clinical treatment.

关 键 词：心肌梗死 青年 预后 心血管事件 影响因素 

分 类 号：R542.2[医药卫生—心血管疾病]