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目的分析青年急性心肌梗死(AMI)患者的临床特点,并探讨其预后影响因素。方法选取2012—2014年汕头市潮南民生医院收治的AMI患者70例,根据性别及年龄分为对照组(男性年龄>45岁或女性年龄>65岁)和观察组(男性年龄≤45岁或女性年龄≤65岁),各35例。比较两组患者的一般资料、实验室检查指标,预后影响因素的分析采用多因素Logistic回归分析。结果两组患者性别、糖尿病发生率、饮酒率比较,差异均无统计学意义(P>0.05);观察组患者住院时间长于对照组,高血压发生率、吸烟率、心肌梗死家族史阳性率均高于对照组(P<0.05)。观察组患者总胆固醇(TC)、三酰甘油(TG)、纤维蛋白原、血红蛋白水平均高于对照组(P<0.05);两组患者低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸、总胆红素水平比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,高血压〔RR=1.897,95%CI(1.557,2.325),P=0.012〕、吸烟〔RR=3.009,95%CI(2.117,4.531),P=0.024〕、心肌梗死家族史〔RR=1.724,95%CI(1.419,2.097),P=0.025〕、血红蛋白〔RR=1.901,95%CI(1.419,2.519),P=0.001〕、TC〔RR=2.291,95%CI(1.968,2.647),P=0.017〕是青年AMI患者预后的影响因素(P<0.05)。结论青年AMI患者高血压发生率、吸烟率、心肌梗死家族史阳性率及TC、TG、纤维蛋白原、血红蛋白水平较高,高血压、吸烟、心肌梗死家族史及血红蛋白、TC是其预后影响因素。
Objective To analyze the clinical features of young patients with acute myocardial infarction (AMI) and to explore the prognostic factors. Methods Seventy patients with AMI who were admitted to Chaonan Minsheng Hospital of Shantou from 2012 to 2014 were divided into control group (male 45 years old or female 65 years old) and observation group (male aged 45 years or younger Female age ≤ 65 years), 35 cases each. The general data of two groups of patients, laboratory test indicators, prognostic factors analysis using multivariate Logistic regression analysis. Results There was no significant difference in gender, diabetes incidence and drinking rate between the two groups (P> 0.05). The length of hospitalization in the observation group was longer than that in the control group. The prevalence rates of hypertension, smoking, and family history of myocardial infarction Higher than the control group (P <0.05). The levels of total cholesterol (TC), triglyceride (TG), fibrinogen and hemoglobin in the observation group were higher than those in the control group (P <0.05). The levels of LDL-C, The levels of HDL-C, serum uric acid and total bilirubin were not statistically different (P> 0.05). Multivariate logistic regression analysis showed that hypertension (RR = 1.897,95% CI 1.557,2.325, P = 0.012), smoking (RR = 3.009,95% CI 2.117, 4.531, P = 0.024) Family history of infarction (RR = 1.724, 95% CI 1.419, 2.097, P = 0.025), hemoglobin [RR = 1.901, 95% CI 1.419, 2.519, CI (1.968,2.647), P = 0.017] were the influencing factors of prognosis in young patients with AMI (P <0.05). Conclusion The incidence of hypertension, smoking rate, positive family history of myocardial infarction and high levels of TC, TG, fibrinogen and hemoglobin, family history of hypertension, smoking, myocardial infarction, hemoglobin and TC are the prognostic factors in young AMI patients .