摘要
目的比较不同性别AMI介入治疗患者之间危险因素的差异,探究AMI患者院内死亡的危险因素,为临床医师尽早对AMI患者进行医学干预提供参考资料。方法回顾性选取2018年1月1日至2019年11月30日于沈阳市某院住院治疗的急性心肌梗死PCI术后患者6457例,比较不同性别之间临床特征差异,和患者院内死亡的危险因素。结果女性组患者年龄、住院时间、高血压史、糖尿病史、高脂血症病史比例及心功能Killip分级≥3级、多支血管病变比例、置入支架数量显著高于男性组患者(P<0.05),医疗付费方式、吸烟史比例显著低于男性组患者(P<0.05)。院内死亡38例,未死亡6419例。多因素分析结果显示,年龄≥65岁(OR:6.25,95%CI:3.36~9.81,P=0.002)、心功能Killip分级≥3级(OR:4.31,95%CI:2.54~6.13,P=0.001)及多支血管病变(OR:2.16,95%CI:1.03~4.46,P=0.009)与院内死亡有统计学关联(P<0.05)。结论 AMI行PCI术的住院女性患者与男性相比,年龄偏大、住院时间偏长、冠状动脉受累偏重、病死率高。而年龄≥65岁、心功能Killip分级≥3级、多支血管病变是发生院内死亡的独立危险因素。
Objective To compare the difference of risk factors between different genders of acute myocardial infarction(AMI) patients in interventional therapy,to explore the risk factors of death of AMI patients in hospital,and to provide reference materials for clinicians to intervene AMI patients as early as possible.Methods The data of all discharged patients in a hospital from January 1,2018 to November 30,2019 were collected.A retrospective analysis of 6457 patients with AMI after PCI.The differences of clinical characteristics between different genders and the risk factors of hospital death were compared.Results The age,length of stay,history of hypertension,history of diabetes,history of hyperlipidemia,Killip grade≥3,the proportion of multi vessel disease and the number of stent implantation in female group were significantly higher than those in male group(P<0.05),and the proportion of medical payment and smoking history was significantly lower than that in male group(P<0.05).The results of multivariate analysis showed that age≥65 years old(OR:6.25,95% CI:3.36-9.81,P-0.002),cardiac function Killip grade≥3(OR:4.31,95% CI:2.54-6.13,P=0.001) and multi vessel disease(OR:2.16,95% CI:1.03-4.46,P=0.009) were significantly associated with hospital death in patients with AMI undergoing PCI.Conclusion Compared with men,the female patients with AMI undergoing PCI were older,longer in hospital,more seriously involved in coronary artery,and had higher mortality.Age≥65 years old,Killip grade≥3 and multi vessel disease were independent risk factors of hospital death.
作者
王攀
Wang Pan(The First affiliated Hospital of China Medical University,Shenyang 110001,Liaoning Province,China)
出处
《中国病案》
2020年第4期51-54,共4页
Chinese Medical Record
关键词
急性心肌梗死
经皮冠状动脉介入术
性别差异
死亡
危险因素
Acute myocardial infarction
Percutaneous coronary intervention
Gender difference
Death
Risk factors
