【摘要】：目的:探討中國非ST段抬高型心肌梗死患者(NSTEMI)住院期間死亡的危險因素。方法:納入2013-01至2014-09期間參加中國急性心肌梗死(CAMI)注冊登記研究的NSTEMI患者5 816例。352例患者在住院期間死亡,為住院期死亡組,余住院期間生存的5 464例患者為住院期生存組。收集患者基線資料、實驗室檢查、治療方法、院內結局等資料,以住院期間死亡為主要結局指標構建多因素Logistic回歸模型,探討NSTEMI患者住院期間死亡獨立危險因素。結果:6.05%(352/5816)的NSTEMI患者在住院期間死亡,兩組患者基線資料存在顯著差異。多因素Logistic回歸分析結果提示,年齡[每增加1歲,比值比(OR)=1.027;95%可信區(qū)間(CI):1.014~1.041;P0.01)、體重指數(shù)(每增加1kg/m~2,OR=0.943;95%CI:0.900~0.988;P0.01)、收縮壓(每增加1 mmH g,OR=0.983;95%CI:0.978~0.988;P0.01)、Killip心功能分級(每增加1級,OR=1.565;95%CI:1.370~1.786;P0.01)、心跳驟停(OR=3.118;95%CI:1.339~7.262;P0.01)、ST段壓低(OR=1.571;95%CI:1.169~2.110;P0.01)、新發(fā)完全性左束支傳導阻滯(OR=4.579;95%CI:1.876~11.177;P0.01)、血肌酐(每增加1μmol/L,OR=1.004;95%CI:1.002~1.005;P0.01)、白細胞計數(shù)(每增加1×109/L,OR=1.100;95%CI:1.071~1.130;P0.01)、從不吸煙(OR=2.080;95%CI:1.460~2.962;P0.01)、既往心肌梗死病史(OR=1.913;95%CI:1.298~2.820;P0.01)、經(jīng)皮冠狀動脈介入治療(PCI)史(OR=0.322;95%CI:0.142~0.729;P0.01)是患者住院期間死亡的獨立危險因素。結論:本研究發(fā)現(xiàn)12個因素是NSTEMI患者住院期間死亡的獨立危險因素,有助于臨床醫(yī)生早期識別高�；颊卟⑦x擇最佳診療策略。
[Abstract]:Objective: to investigate the risk factors of (NSTEMI) death in patients with non-ST segment elevation myocardial infarction in China. Methods: a total of 5,816 NSTEMI patients were enrolled in the (CAMI) registration study between January 2013 and September 2014 in China. 352 patients died during hospitalization. The remaining 5 464 patients who survived during hospitalization were in the hospitalization survival group. The data of baseline data, laboratory examination, treatment method and in-hospital outcome were collected, and the multivariate Logistic regression model was constructed to explore the independent risk factors of death during hospitalization of NSTEMI patients. Results: 6.05% (352 / 5816) of NSTEMI patients died during hospitalization, and there was significant difference in baseline data between the two groups. The results of multivariate Logistic regression analysis showed that age [1 year old, (OR) = 1.027 95% confidence interval (CI): 1.014 + 1.041% P0.01], body mass index (1 kg / m ~ (2) and body mass index (0. 943); 95 CI: 0.900 0. 988 P0.01), systolic blood pressure (0. 983% CI 0. 983% CI 0. 978 0. 988 P0.01), systolic blood pressure (1), Killip per increase, OR=1.565;95%CI:1.370~1.786;). P0.01), cardiac arrest (OR=3.118;95%CI:1.339~7.262;P0.01), ST segment depression (OR=1.571;95%CI:1.169~2.110;P0.01), new complete left bundle branch block (OR=4.579;) The blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01 increase), the white blood cell count (1 脳 10 9 / L) and the CI: 1.071% 1.100% 1.100% CI: 1.100% P0.01), and the blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01), the white blood cell count (1.100%, 1.100%, 1.130% per 1 脳 10 9 / L). P0.01), never smoking (OR=2.080;95%CI:1.460~2.962;P0.01), previous history of myocardial infarction (OR=1.913;95%CI:1.298~2.820;P0.01), (PCI) history of percutaneous coronary intervention (OR=0.322;) 95 CI: 0. 142, 0. 729, P0.01) is an independent risk factor for death in hospital. Conclusion: this study found that 12 factors were independent risk factors for the death of NSTEMI patients during hospitalization, which was helpful for clinicians to identify high-risk patients early and select the best diagnosis and treatment strategy.
【作者單位】： 中國醫(yī)學科學院北京協(xié)和醫(yī)學院國家心血管病中心阜外醫(yī)院冠心病診治中心;中國醫(yī)學科學院北京協(xié)和醫(yī)學院心血管疾病國家重點實驗室;山西省長治市人民醫(yī)院心血管內科;安徽省阜陽市人民醫(yī)院心血管內科;湖北省天門市第一人民醫(yī)院心血管內科;
【基金】：國家“十二·五”科技支撐計劃課題(2011BAI11B02) 公益性行業(yè)科研專項項目(201402001)
【分類號】：R542.22

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