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目的:探讨急性心肌梗死(AMI)病人院内死亡的独立危险因素。方法:回顾性分析我院2011~2013年在我院住院期间,确诊为AMI的患者614例的临床资料,根据AMI患者住院期间存活与否,分为死亡组(62例)和存活组(552例),用单变量和多变量Logistic回归分析所有患者的基线特征因素和治疗方法与院内死亡的关系。结果:62例死亡患者平均年龄(66.58±12.87)岁,男性39例(62.9%),院内死亡率为10.10%(62/614),多变量Logistic回归分析筛选出与AMI院内死亡相关的独立危险因素为:年龄(OR=3.065,95%CI:1.188~7.915)、女性(OR=2.775,95%CI:1.200~6.419)、心率(OR=2.836,95%CI:1.405~5.722)、血糖(OR=1.943,95%CI:1.186~3.184)、Killip IV级(OR=1.744,95%CI:1.211~2.513)、3支或左主干病变(OR=3.157,95%CI:1.244~8.014),P<0.05~<0.01。结论:高龄、女性、心率增快、入院血糖水平高、KillipIV级、3支或左主干病变可能是急性心肌梗死院内死亡的独立危险因素。
Objective: To investigate the independent risk factors for in-hospital mortality in patients with acute myocardial infarction (AMI). Methods: The clinical data of 614 patients diagnosed as AMI during hospitalization from 2011 to 2013 in our hospital were retrospectively analyzed. According to the survival of AMI patients during hospitalization, they were divided into death group (62 cases) and survival group (552 cases) Cases), univariate and multivariate Logistic regression analysis of all patients baseline characteristics and treatment methods and hospital mortality. Results: The average age of 62 deaths was (66.58 ± 12.87) years old, 39 (62.9%) were male and 10.10% (62/614) were hospitalized. Multivariate Logistic regression analysis was used to screen out the independent risk of nosocomial death in AMI (OR = 2.775, 95% CI: 1.200 ~ 6.419), heart rate (OR = 2.836, 95% CI: 1.405-5.722), blood glucose OR = 1.943, 95% CI: 1.186-3.184), Killip class IV (OR = 1.744, 95% CI: 1.211-2.513), three or left main trunk lesions (OR = 3.157, 95% CI: 1.244-8.014) P <0.05 ~ <0.01. CONCLUSION: In elderly patients and women, heart rate and admission blood glucose levels are high. KillipIV grade 3 or left main trunk disease may be an independent risk factor for nosocomial death from acute myocardial infarction.