학술논문
急性心肌梗死住院患者临床特点的性别差异及死亡危险因素分析 / Analysis of clinical characteristics of male and female inpatients with acute myocardial infarction
Document Type
Academic Journal
Author
Source
中国医刊 / Chinese Journal of Medicine. 52(5):30-33
Subject
Language
Chinese
ISSN
1008-1070
Abstract
目的 分析急性心肌梗死(AMI)住院患者临床特点的性别差异及死亡危险因素.方法 采用注册登记研究,登记2011年1月至2012年12月在全国22家医院心内科住院的AMI患者,对这些患者的临床资料、住院诊疗过程和住院结局进行分析.结果 共纳入1968例AMI患者.女性AMI住院患者年龄显著高于男性;女性既往有高血压史(69.6％)、糖尿病史(36.8％)、心力衰竭史(6.4％)的比例显著高于男性(分别为54.3％、22.2％、3.7％),就诊时间(240分钟)晚于男性(180分钟),就诊时心率、血压、LDL水平、并发心力衰竭比例[分别为(78.6±18.2)次/分、(133.6±24.2) mmHg、(2.83±0.95) mmol/L、25.9％]显著高于男性[分别为(76.6±17.4)次/分、(130.8±24.7) mmHg、(2.70±0.87) mmol/L、12.1％] (P＜0.05).诊断和治疗方面,女性患者住院时行冠状动脉造影术、经皮冠状动脉介入治疗的比例(分别为58.1％、46.7％)显著低于男性(分别为74.7％、64.5％),住院期间发生可疑出血事件和死亡的比例(分别为5.1％、8.1％)有显著高于男性(分别为3.0％、3.5％).Logistic回归分析显示:年龄≥70岁,就诊时有心力衰竭、心源性休克,院内出血事件是AMI患者住院死亡的危险因素,而经皮冠状动脉介入治疗是保护性因素.结论 女性AMI住院患者的年龄更大,合并心血管疾病危险因素更显著,就诊时临床情况更差,接受有创检查和再灌注治疗的比例更低,住院期间临床事件显著高于男性.年龄≥70岁、就诊时有心力衰竭、心源性休克、院内出血事件是AMI患者住院死亡的危险因素,而PCI可减少院内死亡.
Objective To analyze the clinical characteristics of male and female inpatients with myocardial infarction.Methods A study was carried in the AMI inpatients with registration from 2011-01 to 2012-12 and the inpatients came from 20 hospitals of all the country.Analyze the clinical information of the inpatients and diagnosis and treatment process and the outcomes in the hospitals.Results There were 1968 inpatients with AMIin all.Compared with male inpatients,female inpatients with myocardial infarction were older (69.58± 11.20)years vs.(60.22± 12.48) years.The female inpatients were more likely to have hypertension(69.6％ vs.54.3％) and diabetes (38.4％ vs.22.2％) and history of heart failure (6.4％ vs.3.7％).For the female AMI inpatients,the time was later between having symptoms to seeing a doctor (240min vs.180min) and the level of LDL (low density lipoprotein) was higher (2.83± 0.95mmol/L vs.2.70± 0.87mmol/L).When the female inpatients were going to see a doctor,the heart rate and the level of systolic blood pressure were higher and they were likely to suffer from heart failure (25.9％ vs.12.1％).In the aspect of diagnosis and treatment,the ratio of female inpatients who underwent PCI (percutaneous coronary intervention) (46.7％ vs.64.5％) and CAG (coronary angiography) (58.1％ vs.74.7％) was lower than male inpatients,while the rate of bleeding events (5.1％ vs.3.0％) and mortality rates (8.1％ vs.3.5％) in the hospital were higher.Analysis of related factors associated with death of all AMI inpatients in hospitals showed that age≥70 years,seeing a doctor with heart failure,cardiac shock and bleeding were risk factors.PCI was protective factor.Conclusion The age of female inpatients with AMI is older,more likely to have cardiovascular risk factors,but less likely to have a chance for receiving reperfusion.Female inpatients with AMI have more clinical events than male inpatients.Age≥70 years,seeing a doctor with heart failure and cardiac shock,bleeding and risk factors and associated with in-hospital mortality.
Objective To analyze the clinical characteristics of male and female inpatients with myocardial infarction.Methods A study was carried in the AMI inpatients with registration from 2011-01 to 2012-12 and the inpatients came from 20 hospitals of all the country.Analyze the clinical information of the inpatients and diagnosis and treatment process and the outcomes in the hospitals.Results There were 1968 inpatients with AMIin all.Compared with male inpatients,female inpatients with myocardial infarction were older (69.58± 11.20)years vs.(60.22± 12.48) years.The female inpatients were more likely to have hypertension(69.6％ vs.54.3％) and diabetes (38.4％ vs.22.2％) and history of heart failure (6.4％ vs.3.7％).For the female AMI inpatients,the time was later between having symptoms to seeing a doctor (240min vs.180min) and the level of LDL (low density lipoprotein) was higher (2.83± 0.95mmol/L vs.2.70± 0.87mmol/L).When the female inpatients were going to see a doctor,the heart rate and the level of systolic blood pressure were higher and they were likely to suffer from heart failure (25.9％ vs.12.1％).In the aspect of diagnosis and treatment,the ratio of female inpatients who underwent PCI (percutaneous coronary intervention) (46.7％ vs.64.5％) and CAG (coronary angiography) (58.1％ vs.74.7％) was lower than male inpatients,while the rate of bleeding events (5.1％ vs.3.0％) and mortality rates (8.1％ vs.3.5％) in the hospital were higher.Analysis of related factors associated with death of all AMI inpatients in hospitals showed that age≥70 years,seeing a doctor with heart failure,cardiac shock and bleeding were risk factors.PCI was protective factor.Conclusion The age of female inpatients with AMI is older,more likely to have cardiovascular risk factors,but less likely to have a chance for receiving reperfusion.Female inpatients with AMI have more clinical events than male inpatients.Age≥70 years,seeing a doctor with heart failure and cardiac shock,bleeding and risk factors and associated with in-hospital mortality.