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目的探讨再发、初发急性心肌梗死(AMI)患者临床病例特点。方法将再发AMI患者37例与同期住院的初发AMI患者233例进行对比,分析其临床特点。结果再发AMI患者与初发AMI患者比较,其危险因素高血压病、糖尿病发生率明显增高(70.3%vs 40.3%,43.2%vs 22.3%,P均<0.05);TC、LDL-C水平较初发组明显增高〔(6.08±1.42)vs(4.67±1.38)mmol/L,(3.91±1.25)vs(2.99±1.00)mmol/L,P均<0.05〕;急诊介入治疗发生率显著降低(45.9%vs 63.1%,P<0.05),保守治疗率显著增加(32.4%vs 15.5%,P<0.05);呼吸困难、心原性休克及病死率均显著增加(40.5%vs 4.3%,29.7%vs 0.9%,27.0%vs 7.3%,P均<0.05)。结论再发AMI患者病情重,容易发生心力衰竭,病死率高。高血压病、糖尿病及高脂血症均是再发AMI的主要危险因素。
Objective To investigate the clinical characteristics of patients with recurrent or initial acute myocardial infarction (AMI). Methods 37 patients with recurrent AMI were compared with 233 newly diagnosed AMI patients hospitalized in the same period, and their clinical features were analyzed. Results The recurrence of AMI patients with AMI patients compared with the risk factors of hypertension, diabetes mellitus incidence was significantly higher (70.3% vs 40.3%, 43.2% vs 22.3%, P all <0.05); TC, LDL-C levels (6.08 ± 1.42) vs (4.67 ± 1.38) mmol / L, (3.91 ± 1.25) vs (2.99 ± 1.00) mmol / L respectively (P <0.05), and the incidence of emergency intervention was significantly decreased (40.5% vs 4.3%, 29.7%, P <0.05). The rates of conservative treatment were significantly higher than those of the control group (45.9% vs 63.1%, P <0.05) vs 0.9%, 27.0% vs 7.3%, P <0.05). Conclusions Patients with recurrent AMI are seriously ill and prone to heart failure with high mortality. Hypertension, diabetes and hyperlipidemia are the major risk factors for recurrent AMI.