本文選題：急性心肌梗死 + 室壁瘤　； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過對急性心肌梗死(Acute myocardial infarction,AMI)合并室壁瘤(Ventricular aneurysm,VA)病史資料、并發(fā)癥、冠狀動脈病變情況、實驗室指標、心臟彩超指標、預(yù)后進行回顧性分析,探討AMI合并VA的臨床特征和危險因素,尋找VA發(fā)生的可控危險因素,并提出干預(yù)措施,為降低臨床VA發(fā)生率和相應(yīng)心血管事件提供資料和證據(jù)。方法:回顧性收集分析遵義醫(yī)學(xué)院心內(nèi)科2010年1月-2016年9月住院期間確診AMI合并VA的患者70例納入研究組,并隨機選取同期不合并VA的AMI患者70例作為對照。通過對2組患者病史資料、并發(fā)癥、冠狀動脈病變情況、實驗室指標、心臟彩超指標、預(yù)后做統(tǒng)計分析,建立AMI合并VA的Logistic回歸模型,尋找VA發(fā)生的可控危險因素。結(jié)果:(1)在單因素分析中,年齡(68.01±11.081 vs 56.93±10.772,P=0.000)、吸煙史(45.71%vs 68.57%,P=0.006)、既往心肌梗死病史(42.85%vs 8.57%,P=0.000)、既往腦卒中病史(32.28%vs 0.00%,P=0.000)、全心衰(14.28%vs0.00%,P=0.001)、單純左心衰(30.00%vs 8.57%,P=0.001)、左心室射血分數(shù)(Left Ventricular Ejection Fraction,LVEF)值降低(90.00%vs 45.55%,P=0.000)、合并腦卒中(30.00 vs 4.28%,P=0.000)、院外1年內(nèi)全因死亡率(10.00%vs 14.28%,P=0.000)、前降支血管病變(95.74%%vs 80.00%,P=0.016)、APOB(0.8380±0.30044 vs 1.0127±.23991,P=0.000)、白細胞升高(28.57 vs 45.71%,P=0.000)在VA和無VA兩組之間均有顯著不同。(2)經(jīng)多因素分析,年齡(OR=1.072b=0.069 P=0.005 95%CI=1.021-1.125)、既往有心肌梗死病史(OR=8.228b=2.108 P=0.002 95%CI=2.120-31.931)、LVEF值降低(OR=6.905b=1.932 P=0.006 95%CI=1.747-27.294)、合并腦卒中(OR=5.483b=1.702 P=0.030 95%CI=1.180-25.474)為VA形成的獨立危險因素。結(jié)論:年齡、既往心肌梗死病史、LVEF值降低和合并腦卒中為VA形成的獨立危險因素。臨床上積極干預(yù)上述危險因素,降低臨床AMI后VA發(fā)生率,改善預(yù)后。
[Abstract]:Objective: to analyze retrospectively the history, complications, coronary artery disease, laboratory indexes, cardiac color Doppler ultrasonography and prognosis of acute myocardial infarction (AMI) with ventricular aneurysm. To explore the clinical characteristics and risk factors of AMI combined with VA, to find out the controllable risk factors of VA, and to provide data and evidence for reducing the incidence of clinical VA and corresponding cardiovascular events. Methods: a retrospective study was conducted on 70 patients with AMI combined with VA from January 2010 to September 2016 in Department of Cardiology, Zunyi Medical College, and 70 AMI patients without VA were randomly selected as control group. Based on the statistical analysis of history, complications, coronary artery disease, laboratory indexes, cardiac color Doppler imaging and prognosis, the Logistic regression model of AMI combined with VA was established to find out the controllable risk factors of VA. Results in univariate analysis, 騫撮緞(68.01鹵11.081 vs 56.93鹵10.772,P=0.000),鍚哥儫鍙，

本文編號：1832714