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目的:肾功能不全在急性冠脉综合症及其它心血管疾病中通常伴随着较高的死亡率。而血浆尿素氮是反映血液动力学改变及肾脏灌注改变的非常敏感的指标。本试验研究血浆尿素氮水平的高低对于急性ST段抬高型心肌梗塞患者死亡率的预测作用。方法:研究300名患急性ST段抬高型心肌梗塞患者长程的死亡率与入院时血浆尿素氮水平及住院时血浆尿素氮水平升高之间的关系。结果:在平均随访27个月,56(18.5%)个患者死亡。使用生存分析对于血浆尿素氮水平升高与血浆尿素氮水平正常两组患者进行研究,用log-rank检验将两组数据进行比较,有明显统计学意义,P<0.001。结论:对于患急性ST段抬高型心肌梗塞患者的长期死亡率,入院时的血浆尿素氮水平是一个独立的预测因素。BUN和BUN/creatinine比值的增高也能对患急性ST段抬高型心肌梗塞患者的长期死亡率提供一定的预测信息。同时,住院期间的BUN增高对于患急性ST段抬高型心肌梗塞患者的长期死亡率也能够提供额外的预测信息。
PURPOSE: Renal dysfunction is often accompanied by high mortality in acute coronary syndromes and other cardiovascular diseases. Plasma urea nitrogen is a very sensitive indicator of hemodynamic changes and renal perfusion changes. This study investigated the level of plasma urea nitrogen in patients with acute ST-elevation myocardial infarction predict the mortality. METHODS: The long-term mortality in 300 patients with acute ST-elevation MI was compared with the plasma urea nitrogen level at hospital admission and the elevated plasma urea nitrogen level during hospitalization. RESULTS: Fifty-six (18.5%) patients died within a mean follow-up of 27 months. Survival analysis of two groups of patients with elevated plasma urea nitrogen levels and normal plasma urea nitrogen levels was performed. Two sets of data were compared using the log-rank test, with significant statistical significance, P <0.001. CONCLUSION: Long-term mortality in patients with acute ST-elevation MI is an independent predictor of plasma urea-N at admission. Increasing the ratio of BUN to BUN / creatinine may also provide some predictive information on long-term mortality in patients with acute ST-elevation MI. At the same time, higher BUN during hospital stay also provides additional predictive information for long-term mortality in patients with acute ST-elevation MI.