高敏心肌肌鈣蛋白Ⅰ陽(yáng)性患者的疾病譜特征分析
發(fā)布時(shí)間：2018-10-22 19:46
【摘要】：目的分析福建省立醫(yī)院高敏心肌肌鈣蛋白I(hs-c Tn I)陽(yáng)性患者疾病譜,以期為臨床工作提供回顧性調(diào)查和分析數(shù)據(jù)。方法回顧性收集2012年8月至2013年11月在福建省立醫(yī)院住院期間連續(xù)檢測(cè)hs-c Tn I的1017例患者,結(jié)合相關(guān)臨床資料、實(shí)驗(yàn)室檢查、臨床診斷及住院轉(zhuǎn)歸,統(tǒng)計(jì)得出hs-c Tn I陽(yáng)性患者疾病譜特征,比較hs-c Tn I陽(yáng)性患者不同年齡、性別、季節(jié)、腎功能的疾病譜差異,以及hs-c Tn I水平不同程度升高的疾病譜差異。運(yùn)用logistic回歸分析住院死亡與住院死亡危險(xiǎn)因素的關(guān)系。結(jié)果1.hs-c Tn I陽(yáng)性患者中急性冠狀動(dòng)脈綜合征(ACS)占51.7%,非ACS占48.3%;其中最常見的5種疾病分別為ST段抬高型心肌梗死(STEMI)、心律失常、非ST段抬高型心肌梗死(NSTEMI)、心力衰竭、穩(wěn)定型冠心病,所占比例分別為28.2%、23.3%、17.4%、17.0%、10.4%。不同性別分析,男性和女性最常見的5種疾病均為STEMI、心律失常、NSTEMI、心力衰竭、穩(wěn)定型冠心病。2.按不同年齡分組,hs-c Tn I陽(yáng)性患者常見的5種疾病均為STEMI、心律失常、NSTEMI、心力衰竭、穩(wěn)定型冠心病,各年齡段疾病的構(gòu)成比略有不同;非心血管系統(tǒng)疾病中,60歲以下人群以嚴(yán)重創(chuàng)傷、心肺復(fù)蘇術(shù)后、蛛網(wǎng)膜下腔出血多見,60歲以上人群以慢性腎衰竭、腦卒中、消化道出血為主,而膿毒血癥在各年齡段的疾病譜中所占構(gòu)成比大致相似。3.按估計(jì)的腎小球?yàn)V過率分為腎功能正常組、輕度腎功能不全組、中度腎功能不全組和重度腎功能不全組,腎功能正常組、輕度腎功能不全組、中度腎功能不全組最常見的5種疾病均為STEMI、心律失常、NSTEMI、心力衰竭、穩(wěn)定型冠心病,構(gòu)成比略有不同;而重度腎功能不全組最常見的5種疾病分別為心力衰竭、穩(wěn)定型冠心病、心律失常、NSTEMI、膿毒血癥。4.按hs-c Tn I界值的10倍分為輕度升高組、中度升高組、重度升高組和極重度升高組,結(jié)果顯示最常見的5種疾病中,STEMI、NSTEMI見于中度以上升高組;穩(wěn)定型冠心病、慢性腎衰竭、膿毒血癥僅見于中度以下升高組;重度以下升高組可見心律失常、心力衰竭、心臟外科術(shù)后。非心血管系統(tǒng)疾病,消化道出血僅見于輕度升高組;心肺復(fù)蘇術(shù)后、嚴(yán)重創(chuàng)傷僅見于重度升高組。5.hs-c Tn I陽(yáng)性患者中ACS組住院病死率為7.0%,非ACS組住院病死率為12.6%,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05);二元logistic回歸分析示中度以上腎功能不全組的住院死亡風(fēng)險(xiǎn)是輕度以下腎功能不全組的2.263倍(OR值為2.263,P0.05);而年齡、性別、hs-c Tn I、氨基末端腦鈉肽前體均未增加ACS組患者與非ACS患者的住院死亡風(fēng)險(xiǎn)。結(jié)論hs-c Tn I陽(yáng)性疾病譜中常見的5種疾病為STEMI、心律失常、NSTEMI、心力衰竭、穩(wěn)定型冠心病;ACS占51.7%,非ACS占48.3%;ACS患者住院病死率為7.0%,非ACS患者住院病死率為12.6%。
[Abstract]:Objective to analyze the spectrum of cardiac troponin I (hs-c Tn I) positive patients in Fujian Provincial Hospital, so as to provide retrospective investigation and analysis data for clinical work. Methods 1017 patients with hs-c Tn I were collected from August 2012 to November 2013 in Fujian Provincial Hospital. Combined with clinical data, laboratory examination, clinical diagnosis and outcome of hospitalization, 1017 patients were enrolled in this study. The disease spectrum characteristics of hs-c Tn I positive patients were statistically analyzed, and the differences of disease spectrum of hs-c Tn I positive patients with different age, sex, season and renal function were compared, as well as the difference of disease spectrum with different degree of hs-c Tn I level. Logistic regression analysis was used to analyze the relationship between hospital mortality and risk factors of hospital death. Results among the patients with 1.hs-c Tn I positive, acute coronary syndrome (ACS) accounted for 51.7%, non-ACS for 48.3%, and ST segment elevation myocardial infarction (ST) (STEMI), arrhythmia, non-ST segment elevation myocardial infarction (NSTEMI),) heart failure, stable coronary heart disease (CHD), among which the most common diseases were ST segment elevation myocardial infarction (STEMI), arrhythmia, non-ST segment elevation myocardial infarction (NSTEMI), heart failure and stable coronary heart disease. The percentages were 28.2and 23.3and 17.4and 17.0and 10.4, respectively. By sex analysis, the five most common diseases in both men and women were STEMI, arrhythmia, NSTEMI, heart failure, and stable coronary heart disease. 2. 2. According to different age groups, five common diseases of hs-c Tn I positive patients were STEMI, arrhythmia, NSTEMI, heart failure, stable coronary heart disease. After cardiopulmonary resuscitation, subarachnoid hemorrhage was more common. Chronic renal failure, cerebral apoplexy and gastrointestinal hemorrhage were the main causes in patients over 60 years old. According to the estimated glomerular filtration rate, they were divided into normal renal function group, mild renal insufficiency group, moderate renal insufficiency group and severe renal insufficiency group, normal renal function group, mild renal insufficiency group, and mild renal insufficiency group. The five most common diseases in moderate renal insufficiency group were STEMI, arrhythmia, NSTEMI, heart failure, stable coronary heart disease, and the composition ratio was slightly different, while the most common five diseases in severe renal insufficiency group were heart failure and stable coronary heart disease. Arrhythmia, NSTEMI, sepsis. According to the 10 times of the hs-c Tn I threshold, the patients were divided into three groups: mild elevated group, moderate elevated group, severe elevated group and extremely severe elevated group. The results showed that among the five most common diseases, STEMI,NSTEMI was found in moderate elevation group, stable coronary heart disease group, chronic renal failure group, stable coronary heart disease group, chronic renal failure group, stable coronary heart disease group, chronic renal failure group, Sepsis was only found in patients below moderate elevation, and arrhythmia, heart failure and cardiac surgery were found in patients below severe elevation. Non-cardiovascular diseases, gastrointestinal bleeding only seen in mild elevated group; after cardiopulmonary resuscitation, Severe trauma was found only in severe elevated group. The mortality of ACS group was 7.0, and that of non-ACS group was 12.6 in 5.hs-c Tn I positive group, there was significant difference between the two groups (P0.05). Binary logistic regression analysis showed moderate renal insufficiency group. The risk of death in hospital was 2.263 times as high as that in patients with mild renal insufficiency (OR = 2.263, P 0.05); age, however, was significantly higher than that in patients with mild renal insufficiency (P < 0.05). Sex, hs-c Tn I, and amino terminal brain natriuretic peptide precursors did not increase the risk of hospital death in ACS patients and non-ACS patients. Conclusion STEMI, arrhythmia, NSTEMI, heart failure and stable coronary heart disease are common diseases in hs-c Tn I positive disease spectrum, ACS is 51.7%, non-ACS is 48.3%, hospital mortality is 7.0 and non-ACS is 12.6%.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R54
本文編號(hào)：2288129
[Abstract]:Objective to analyze the spectrum of cardiac troponin I (hs-c Tn I) positive patients in Fujian Provincial Hospital, so as to provide retrospective investigation and analysis data for clinical work. Methods 1017 patients with hs-c Tn I were collected from August 2012 to November 2013 in Fujian Provincial Hospital. Combined with clinical data, laboratory examination, clinical diagnosis and outcome of hospitalization, 1017 patients were enrolled in this study. The disease spectrum characteristics of hs-c Tn I positive patients were statistically analyzed, and the differences of disease spectrum of hs-c Tn I positive patients with different age, sex, season and renal function were compared, as well as the difference of disease spectrum with different degree of hs-c Tn I level. Logistic regression analysis was used to analyze the relationship between hospital mortality and risk factors of hospital death. Results among the patients with 1.hs-c Tn I positive, acute coronary syndrome (ACS) accounted for 51.7%, non-ACS for 48.3%, and ST segment elevation myocardial infarction (ST) (STEMI), arrhythmia, non-ST segment elevation myocardial infarction (NSTEMI),) heart failure, stable coronary heart disease (CHD), among which the most common diseases were ST segment elevation myocardial infarction (STEMI), arrhythmia, non-ST segment elevation myocardial infarction (NSTEMI), heart failure and stable coronary heart disease. The percentages were 28.2and 23.3and 17.4and 17.0and 10.4, respectively. By sex analysis, the five most common diseases in both men and women were STEMI, arrhythmia, NSTEMI, heart failure, and stable coronary heart disease. 2. 2. According to different age groups, five common diseases of hs-c Tn I positive patients were STEMI, arrhythmia, NSTEMI, heart failure, stable coronary heart disease. After cardiopulmonary resuscitation, subarachnoid hemorrhage was more common. Chronic renal failure, cerebral apoplexy and gastrointestinal hemorrhage were the main causes in patients over 60 years old. According to the estimated glomerular filtration rate, they were divided into normal renal function group, mild renal insufficiency group, moderate renal insufficiency group and severe renal insufficiency group, normal renal function group, mild renal insufficiency group, and mild renal insufficiency group. The five most common diseases in moderate renal insufficiency group were STEMI, arrhythmia, NSTEMI, heart failure, stable coronary heart disease, and the composition ratio was slightly different, while the most common five diseases in severe renal insufficiency group were heart failure and stable coronary heart disease. Arrhythmia, NSTEMI, sepsis. According to the 10 times of the hs-c Tn I threshold, the patients were divided into three groups: mild elevated group, moderate elevated group, severe elevated group and extremely severe elevated group. The results showed that among the five most common diseases, STEMI,NSTEMI was found in moderate elevation group, stable coronary heart disease group, chronic renal failure group, stable coronary heart disease group, chronic renal failure group, stable coronary heart disease group, chronic renal failure group, Sepsis was only found in patients below moderate elevation, and arrhythmia, heart failure and cardiac surgery were found in patients below severe elevation. Non-cardiovascular diseases, gastrointestinal bleeding only seen in mild elevated group; after cardiopulmonary resuscitation, Severe trauma was found only in severe elevated group. The mortality of ACS group was 7.0, and that of non-ACS group was 12.6 in 5.hs-c Tn I positive group, there was significant difference between the two groups (P0.05). Binary logistic regression analysis showed moderate renal insufficiency group. The risk of death in hospital was 2.263 times as high as that in patients with mild renal insufficiency (OR = 2.263, P 0.05); age, however, was significantly higher than that in patients with mild renal insufficiency (P < 0.05). Sex, hs-c Tn I, and amino terminal brain natriuretic peptide precursors did not increase the risk of hospital death in ACS patients and non-ACS patients. Conclusion STEMI, arrhythmia, NSTEMI, heart failure and stable coronary heart disease are common diseases in hs-c Tn I positive disease spectrum, ACS is 51.7%, non-ACS is 48.3%, hospital mortality is 7.0 and non-ACS is 12.6%.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R54
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 姜紅;葛均波;;心力衰竭流行病學(xué)特點(diǎn)[J];中國(guó)醫(yī)學(xué)前沿雜志(電子版);2010年01期
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