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目的调查台州地区近10年急性心肌梗死(AMI)患者的特征、治疗模式和住院转归。方法采用回归性分析研究台州医院197AMI患者的住院病历,选取2001年25例、2006年59例、2011年113例AMI患者,其中男137例(69.5%),女60例(30.5%),年龄34~87(65.40±11.64)岁。ST段抬高型心肌梗死176例(80.3%),非ST段抬高型心肌梗死21例(10.7%);前壁心肌梗死97例(49.2%),下壁心肌梗死56例(28.4%),后壁心肌梗死13例(6.6%);吸烟82例(41.6%),高血压104例(52.8%),糖尿病34例(17.3%),有冠心病史27例(13.7%)。结果 2011年AMI患者血糖、cTnI峰值、入院时CK-MB、CK-MB峰值高于2001、2006年,差异均有统计学意义(均P<0.05),2011年AMI患者从发病距入院时间短于2001、2006年(均P<0.05)。2011年直接经皮冠状动脉介入(PCI)比例高于2001、2006年(均P<0.05)。2011年院内再发心绞痛、主要不良心血管事件低于2006年(均P<0.05)。多元logistic回归分析显示,恶性心律失常(OR=114.030,P<0.01)和院内再发心肌梗死(OR=75.720,P<0.05)是AMI患者院内死亡的危险因素。结论本研究反映了台州地区近10年来AMI的趋势及治疗结果。AMI患者直接PCI比例提高,院内再发心绞痛、主要不良心血管事件显著减少。
Objective To investigate the characteristics, treatment modalities and hospitalization of patients with acute myocardial infarction (AMI) in Taizhou in recent 10 years. Methods A retrospective analysis was performed to study the hospitalization records of 197 AMI patients in Taizhou Hospital. Totally 25 cases were in 2001, 59 cases in 2006 and 113 cases were AMI in 2011. There were 137 males (69.5%) and 60 females (30.5%), 34 ~ 87 (65.40 ± 11.64) years old. There were 176 cases (80.3%) of ST segment elevation myocardial infarction, 21 cases (10.7%) of non ST elevation myocardial infarction, 97 cases (49.2%) anterior myocardial infarction and 56 cases (28.4%) inferior myocardial infarction 13 cases (6.6%) had posterior myocardial infarction, 82 cases (41.6%) smoked, 104 cases (52.8%) had hypertension, 34 cases (17.3%) had diabetes, and 27 cases (13.7%) had coronary heart disease. Results The peak values of blood glucose and cTnI in patients with AMI in 2011 were higher than those of patients in 2001 and 2006 (all P <0.05). In 2011, the peak of CK-MB and CK- In 2001 and 2006 (all P <0.05). Direct percutaneous coronary intervention (PCI) in 2011 was higher than in 2001 and 2006 (all P <0.05). In 2011, angina was recurred in hospital, and the main adverse cardiovascular events were lower than those in 2006 (all P <0.05). Multivariate logistic regression analysis showed that malignant arrhythmia (OR = 114.030, P <0.01) and hospital recurrent myocardial infarction (OR = 75.720, P <0.05) were risk factors for in-hospital mortality in patients with AMI. Conclusions This study reflects the trends and treatment outcomes of AMI in Taizhou over the past 10 years. AMI patients with increased proportion of direct PCI, hospital recurrent angina, a significant reduction in major adverse cardiovascular events.