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目的:探讨影响基层医院急性心肌梗死(acute myocardial infarction,AMI)患者静脉溶栓效果的相关因素,通过Logistic回归分析,探究相关的危险性因素,为临床治疗策略的制定提供依据。方法:回顾分析2012年1月-2013年12月本院心血管内科住院使用尿激酶溶栓的AMI患者86例,根据患者溶栓治疗后血管是否开通分为开通组47例和未开通组39例,比较两组的一般临床资料。以血管是否开通为因变量,对可能的相关影响因素包括BMI、溶栓时间、糖尿病、不稳定型心绞痛、吸烟以及前壁相关性心肌梗死进行Logistic回归分析。确定相应的危险因素。结果:86例AMI溶栓患者中,47例血管成功开通。开通组和未开通组比较。前者的BMI较大、溶栓时间较短、糖尿病患病率较低、不稳定型心绞痛发生率较低、吸烟比例较高以及前壁相关性心肌梗死的比例较高。Logistic回归分析的结果发现溶栓时间>5h、糖尿病、不稳定型心绞痛、非前壁相关性心肌梗死等4个因素均为血管开通失败的危险因素。结论:基层医院接诊的AMI患者若合并糖尿病、既往有不稳定型心绞痛、溶栓时间>5 h或心肌梗死部位为非前壁相关性心梗时.建议尽早转运至上级医院介入中心处理。
Objective: To explore the influencing factors of intravenous thrombolysis in patients with acute myocardial infarction (AMI) in primary hospitals, to explore relevant risk factors through Logistic regression analysis, and to provide evidence for the development of clinical treatment strategies. Methods: A retrospective analysis of 86 patients with AMI who were hospitalized with urokinase thrombolysis in our hospital from January 2012 to December 2013 was divided into open group (n = 47) and open group (n = 39) according to whether the blood vessels were opened after thrombolytic therapy Cases, the two groups of general clinical data. Logistic regression analysis was performed on the possible related factors including BMI, thrombolytic time, diabetes mellitus, unstable angina, smoking, and anterior wall-associated myocardial infarction, with or without blood vessel opening as the dependent variable. Determine the corresponding risk factors. Results: In 86 patients with AMI thrombolysis, 47 cases of blood vessels were successfully opened. Open group and open group comparison. The former has a larger BMI, shorter thrombolysis time, lower prevalence of diabetes, lower incidence of unstable angina, higher smoking prevalence, and higher rates of anterior myocardial infarction. Logistic regression analysis showed that the four factors of thrombolysis time> 5h, diabetes mellitus, unstable angina pectoris and non-anterior wall-associated myocardial infarction were the risk factors for failure of blood vessel opening. Conclusions: AMI patients admitted to grassroots hospitals with unstable angina pectoris, diabetes mellitus, thrombolysis time> 5 h, or myocardial infarction are non-anterior wall-associated myocardial infarction.