摘要
目的探讨影响急性心肌梗死(acute myocardial infarction,AMI)后生存时间的因素。方法 2002-01至2004-12入选的453例AMI患者,于出院后进行随访,截止时间是2009-12。对入选时及最近一次随访病例资料进行回顾性研究。使用寿命表法分析生存率,多因素COX回归法对影响AMI患者生存时间的因素进行分析。结果 AMI患者5年生存率为93%,6年生存率为91%影响AMI生存时间的主要因素是糖尿病史(RR=2.606,95%CI:1.233～5.509)、高血压史(RR=3.31 1,95%CI:1.325～8.271)、年龄(RR=1.041,95%C1:1.009～1.074)、随访NYHA等级(RR=2.043,95%CI:1.241～3.363)、再血管化(RR=2.485,95%CI:1.143～5.404)、随访LVEDD(RR=1.058,95%CI:1.003～1.115)、随访LVESV(RR=1.020,95%CI:1.008～1.031)。结论糖尿病史、高血压史、年龄、再血管化、随访NYHA等级、LVEDD、LVESV是独立危险因素。心肌梗死后积极地采取药物干预心室重塑,维持血压及血糖的正常平稳及尽早再血管化是改善心室重构,防治心力衰竭的关键因素,对心肌梗死患者远期预后和长期生存率有重要影响。
Objective To investigate the relevant factors of mortality in the follow -up period after acute myocardial infaretion. Methods 453 patients with acute myocardial infaretion（AMI） from January 2002 to December 2004 were recruited and followed up after discharge till December 2009. The survival rate of AMI was obtained by using life table analysis. The independent factors of the survival time after AMI were obtained by Cox regression analysis. Results The survival rate of five years and six years was 93% and 91% , respectively. The histury of diabetes mellitus （ RR = 2. 606,95% CI：1. 233 -5. 509 ）, history of hypertension （ RR = 3. 311,95% CI：1. 325 - 8.271 ） , age （ RR = 1. 041,95 % CI ： 1. 009 - 1. 074 ） , followed up NYHA （ RR = 2. 043,95 % CI ： 1. 241 - 3. 363 ） , revascularization （ RR = 2. 485,95% CI： 1. 143 - 5. 404） , follow - up LVEDD（ RR = 1. 058,95% CI： 1. 003 - 1. 115 ） , followed up LVESV （ RR = 1. 020,95% CI ： 1. 008 - 1. 031 ） were determined in the model with multivariate COX regression analysis. Conclusions The history of diabetes mellitus and hypertension, age, followed up NYHA, LVEDD and LVESV, and revascularization were independent tactors. Punctual administration of drugs to intervene ventricular remodeling, maintaining normal blood pressure and blood sugar and the earliest possible revascularization after myocardial infarction are the most important determinants of prognosis and long - term survival.
出处
《武警医学》
CAS
2011年第7期593-595,共3页
Medical Journal of the Chinese People's Armed Police Force
基金
"十五"全军医药卫生科研基金课题重点资助项目(01Z036)
