本文選題：心肌梗死 + 非ST段抬高型急性心肌梗死��； 參考：《山東醫(yī)藥》2016年11期

【摘要】：目的探討老年非ST段抬高型急性心肌梗死(NSTEMI)患者的臨床特征及預(yù)后影響因素。方法 135例老年急性心肌梗死患者,其中NSTEMI患者72例、ST段抬高型急性心肌梗死(STEMI)患者63例,比較NSTEMI與STEMI患者的臨床資料,同時(shí)采用Cox回歸模型分析影響老年NSTEMI患者預(yù)后的相關(guān)因素。結(jié)果 NSTEMI、STEMI患者中糖尿病分別為30、12例,高血壓分別為49、31例,持續(xù)性胸痛分別為40、53例,心力衰竭分別為45、27例,肌酸激酶峰值分別為(829.55±125.64)、(2 354.45±351.01)IU/L,肌鈣蛋白I峰值分別為(0.86±0.24)、(1.86±0.64)ng/m L,兩者比較,P均0.05。出院后1年期間內(nèi),NSTEMI患者再發(fā)心絞痛發(fā)生率、心力衰竭發(fā)生率和病死率均高于STEMI患者(24.3%vs.11.7%,18.6%vs.6.7%,25.7%vs.8.3%),P均0.05。高齡(65歲)(HR=2.13)、心力衰竭(HR=3.37)和入院時(shí)Killip≥3級(jí)(HR=1.79)為老年NSTEMI患者近期預(yù)后的危險(xiǎn)因素,服用阿司匹林(HR=0.51)為老年NSTEMI患者近期預(yù)后的保護(hù)因素。結(jié)論與老年STEMI患者相比,老年NSTEMI患者合并糖尿病、高血壓和心力衰竭更多,持續(xù)性胸痛更少,肌酸激酶峰值和肌鈣蛋白I峰值更低。老年NSTEMI患者遠(yuǎn)期預(yù)后較差,高齡(65歲)、伴心力衰竭和入院時(shí)Killip≥3級(jí)老年NSTMEI患者預(yù)后風(fēng)險(xiǎn)增加,服用阿司匹林老年NSTMEI患者預(yù)后風(fēng)險(xiǎn)降低。
[Abstract]:Objective to investigate the clinical features and prognostic factors of elderly patients with non-St segment elevation acute myocardial infarction (NSTEMI). Methods the clinical data of 135 elderly patients with acute myocardial infarction (AMI), including 72 patients with STEMI and 63 patients with STEMI, were compared between NSTEMI and STEMI. Cox regression model was used to analyze the prognostic factors of elderly patients with NSTEMI. Results there were 12 cases of diabetes mellitus, 31 cases of hypertension, 4053 cases of persistent chest pain, 27 cases of heart failure, (829.55 鹵125.64), (2 354.45 鹵351.01) ng/m / L of creatine kinase and (0.86 鹵0.24), (鹵0.86 鹵0.64) ng/m / L of cardiac troponin I, respectively. The incidence of recurrent angina pectoris, heart failure and mortality in patients with NSTEMI within one year after discharge were higher than those in patients with STEMI (24.3vs.11.70.18.6vs.6.7%) (P < 0.05). Old age (65 years) (HR2.13), heart failure (HR3.37) and admission Killip 鈮，

本文編號(hào)：2083479