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目的探讨急性心肌梗死(AMI)并发初诊心力衰竭住院患者的生存状况。方法将本院收治的160例AMI患者按住院期间是否并发心力衰竭分为心力衰竭组和非心力衰竭组。采用自制表格统计患者一般资料和相关指标。结果 160例AMI患者中58例(36.25%)确诊为首发心力衰竭。两组患者在年龄、心率、发病至就诊时间、住院时间、左心室射血分数(LVEF)、合并慢性阻塞性肺疾病比例、肌酸激酶同工酶(CK-MB)、血肌酐(SCr)和血清尿素氮(BUN)方面比较差异均具有显著性(P<0.05或P<0.01)。心力衰竭组患者总死亡率、心房颤动、心源性休克和室性心律失常发病率均显著高于非心力衰竭组(P<0.01)。Logistic回归分析显示,影响AMI患者住院死亡率的因素由高至低依次为Killip分级、并发心源性休克、并发心力衰竭、并发慢性阻塞性肺疾病、LVEF、年龄和CKMB。结论 AMI首发心力衰竭患者死亡率较高,预后较差,应及时检测相关指标,积极预防AMI患者发生心力衰竭,有助于改善患者预后。
Objective To investigate the survival status of hospitalized patients with acute myocardial infarction (AMI) complicated with newly diagnosed heart failure. Methods A total of 160 patients with AMI admitted to our hospital were divided into heart failure group and non-heart failure group according to whether hospitalized with heart failure. The use of self-made forms of statistical data and related indicators of patients. Results Of the 160 patients with AMI, 58 (36.25%) were diagnosed with first heart failure. Two groups of patients in the age, heart rate, onset to treatment time, length of stay, left ventricular ejection fraction (LVEF), the proportion of patients with chronic obstructive pulmonary disease, creatine kinase (CK-MB), serum creatinine And serum urea nitrogen (BUN) were significantly different (P <0.05 or P <0.01). The incidence of total mortality, atrial fibrillation, cardiogenic shock and ventricular arrhythmia in heart failure patients were significantly higher than those in non-heart failure patients (P <0.01). Logistic regression analysis showed that the factors affecting the in-hospital mortality rate of AMI patients were Killip grading from high to low, with cardiogenic shock, complicated with heart failure, chronic obstructive pulmonary disease, LVEF, age and CKMB. Conclusion The mortality of AMI patients with heart failure is high and their prognosis is poor. Relevant indexes should be tested in time to prevent AMI patients from heart failure and improve their prognosis.