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目的 :探讨影响老年人急性心肌梗死 (AMI)近期预后的危险因素。方法 :将 10 5例 6 0岁以上的AMI患者 ,据发病后 4周内的预后分成存活组和死亡组 2组。对发病时的年龄、性别、吸烟史 ,是否合并高血压病、糖尿病、高血脂症及AMI发病后 2 4h内TG、TC水平用t检验或 χ2 检验方法 ,进行单因素分析 ;同时对影响老年人AMI预后的相关危险因素进行多元Logistic回归分析。结果 :单因素分析显示 :年龄、吸烟、高TC血症及AMI发病后 2 4h内的TG和TC水平在存活组和死亡组之间有显著性差异。多因素分析发现年龄每增加 1岁 ,其死亡危险性增加 1 0 6 6倍 ;吸烟者的死亡危险性是非吸烟者的 7 0 6 0倍 ;有高TC血症史者的死亡危险性是无高TC血症史者的 5 899倍 ;AMI发生 2 4h内的TC水平每增加 1 0 0mmol/L ,其死亡危险性增加 1 84 5倍。结论 :年龄、吸烟史、高胆固醇血症史及AMI发生 2 4h内的血清总TC水平是影响老年人AMI近期预后的高危因素。
Objective: To explore the risk factors that affect the short-term prognosis of elderly patients with acute myocardial infarction (AMI). Methods: A total of 105 patients with AMI over 60 years old were divided into two groups according to their prognosis within 4 weeks after their onset: survival group and death group. T-test or χ2 test was used to analyze the level of TG and TC in patients with hypertension, diabetes, hyperlipidemia and the incidence of AMI within 24 hours after onset on the basis of age, sex, smoking history, univariate analysis, Multivariate Logistic regression analysis was performed on the risk factors associated with the prognosis of AMI. Results: Univariate analysis showed that age, smoking, hypercholesteremia and TG and TC levels within 24 hours after onset of AMI were significantly different between survivors and death patients. Multivariate analysis showed that the risk of death increased by 1 0 6 6 times for each 1-year-old age increase; the risk of death among smokers was 70 6 times higher than that of non-smokers; and the risk of death from those with history of hypercholesteremia was 5 899 times higher than the history of high TC hyperlipidemia; every increase of TC level within 24 hours after AMI increased the risk of death by 1845 times. CONCLUSIONS: The age, smoking history, history of hypercholesterolemia, and total serum TC levels within 24 hours of onset of AMI are risk factors that affect the short-term prognosis of AMI in the elderly.