本文選題：急性ST段抬高型心肌梗死 + 預(yù)后��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討急性ST段抬高型心肌梗死患者短期預(yù)后的影響因素。方法:連續(xù)收集2012年至2016年心血管科收住的急性STEMI患者并進(jìn)行為期30天的隨訪,一共納入348例患者,根據(jù)患者有無發(fā)生主要不良心臟事件分為事件組(106例)和對(duì)照組(242例),通過對(duì)比兩組的基本情況、實(shí)驗(yàn)室檢查、心電圖和影像學(xué)檢查及治療方法,分析影響兩組間預(yù)后因素的差異。結(jié)果:對(duì)兩組急性ST段抬高型心肌梗死患者進(jìn)行單因素分析顯示:年齡、首診心率、收縮壓、舒張壓、血鉀、尿素氮、血肌酐、尿酸、隨機(jī)血糖、高密度脂蛋白、C-反應(yīng)蛋白、D-二聚體、糖化血紅蛋白、糖尿病病史、心肌梗死病史方面的差異均有統(tǒng)計(jì)學(xué)意義。而性別、院前延誤時(shí)間、吸煙、住院天數(shù)、膽固醇、甘油三脂、低密度脂蛋白、腦鈉肽、同型半胱氨酸、前壁心肌梗死、左室縮短分?jǐn)?shù)、左室射血分?jǐn)?shù)、高血壓病史、腦血管意外病史、溶栓治療的差別無統(tǒng)計(jì)學(xué)意義。對(duì)上述有意義的指標(biāo)納入多因素Logistic回歸表明,隨機(jī)血糖7.0mmol/l(OR=1.228,95%CI:1.198~1.240,P0.001)、首診心率76次/分(OR=1.048,95%CI:1.024~1.073,P0.001)、血尿素氮5.3mmol/l(OR=1.136,95%CI:1.007~1.281,P=0.038)、C-反應(yīng)蛋白7.35mg/l(OR=1.017,95%CI:1.006~1.028,P=0.002)均是發(fā)生主要不良心臟事件的危險(xiǎn)因素,首診舒張壓75mmHg(OR=0.942,95%CI:0.915~0.969,P0.001)、PCI治療(OR=0.542,95%CI:0.331~0.889,P=0.015)是保護(hù)因素。結(jié)論:隨機(jī)血糖高、心率快、腎功能不全、炎癥均是急性心肌梗死患者發(fā)生主要不良心臟事件的危險(xiǎn)因素。維持舒張壓、PCI治療有益于急性心肌梗死患者的短期預(yù)后,而與既往高血壓病史相關(guān)性不明顯。
[Abstract]:Objective: to investigate the influence factors of short-term prognosis in patients with acute St-segment elevation myocardial infarction. Methods: a total of 348 patients with acute STEMI were collected from 2012 to 2016 and followed up for 30 days. According to the occurrence of major adverse cardiac events, the patients were divided into two groups: the event group (106 cases) and the control group (242 cases). By comparing the basic conditions of the two groups, laboratory examination, electrocardiogram and imaging examination and treatment, The difference of prognostic factors between the two groups was analyzed. Results: univariate analysis showed that age, heart rate, systolic blood pressure, diastolic blood pressure, blood potassium, urea nitrogen, serum creatinine, uric acid, and random blood glucose in two groups of patients with acute ST-segment elevation myocardial infarction. There were significant differences in D-dimer, glycosylated hemoglobin, history of diabetes and myocardial infarction. Sex, pre-hospital delay, smoking, hospitalization days, cholesterol, triglyceride, low density lipoprotein, brain natriuretic peptide, homocysteine, anterior wall myocardial infarction, left ventricular shortening score, left ventricular ejection fraction, hypertension history, There was no significant difference in the history of cerebrovascular accident and thrombolytic therapy. 瀵逛笂榪版湁鎰忎箟鐨勬寚鏍囩撼鍏ュ鍥犵礌Logistic鍥炲綊琛ㄦ槑,闅忔満琛，

本文編號(hào)：1774697