周宝森,王天爵,时景璞,林东芳.急性心肌梗塞急性期预后多因素分析——非条件Logistic模型[J].Chinese journal of Epidemiology,1994,15(2):99-102 |
急性心肌梗塞急性期预后多因素分析——非条件Logistic模型 |
Multivariate Analysis on Prognostic Factors for Acute Myocardial Infarction during Acute Period Noncondition Stepwise Logistic Model |
Received:March 27, 1993 Revised:June 19, 1993 |
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KeyWord: 急性心肌梗塞 预后 病死率 |
English Key Word: Acute myocardial infarction Prognosis Case fatality rate |
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Abstract: |
急性心肌梗塞是一常见的预后较严重的心血管疾病,急性期预后受多因素影响。本文用多因素非条件Logistic模型分析报道了319例急性心肌梗塞,其中存活262例,死亡57例。急性期病死率为17.9%。年龄增大,预后越差,大于60岁的病死率为>23.4%,高于60岁以下的12.8%。结果心衰、年龄、心律失常、肺内感染、心梗部位、高血压病史20年以上,为急性期影响预后的主要因素。血清高密度脂蛋白对急性期死亡有保护作用.本文提出,挽救缺血的心肌,避免心衰是治疗急性心肌梗塞的根本措施。同时,控制肺内感染和恢复正常心律是一项必备的治疗措施。对患有高血压病史的人,应作为心肌梗塞的高危险人群,采取积极防治措施。 |
English Abstract: |
The relationship between baseline factors defined at 4.3±1.8 hr after onset of acute myocardial infarction and 28-day survival in 319 patients admitted into the China Medical University was evaluated.The case fatality rate during acute period was 17.9%. Univariate statistics identified a significant relationship between 5 of these factors and survival. Multivariate noncondition stepwise logistic model analysis identified four factors as being most closely related to survival : (1) heart failure; (2) arrhythmia; (3) age; (4) history of essential hypertension. It is concluded that heart failure during the acute period of acute myocardial infarction is the most important baseline factor for prediction of 28-day survival. |
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