标题：2009—2018年登封市急性心肌梗死患者临床特征趋势及院内死亡危险因素分析

      作者：任怡辉，郭杏花，贺小武，闫建丽，宋小平，王晓飞，詹继斌，郭晓伟，范丽渊，耿宏旭    登封市人民医院心内科，河南 登封 452470

      卷次： 2019年30卷18期

      【摘要】 目的 探讨登封市 10年来急性心肌梗死患者的临床特征变化趋势及住院期间死亡的相关危险因素。方法 回顾性分析登封市人民医院2009年1月1日至2018年12月28日收治并确诊的1 496例急性心肌梗死患者的临床诊治资料，对每年患者的总数、年龄、性别、临床症状及特征、心肌梗死类型、治疗方式和住院期间预后进行统计分析。结果 1 496例急性心肌梗死患者的平均年龄(64.37±13.46)岁，合并高血压病史或入院时血压增高比例达70.0%，男女之比为2.07∶1，急性ST段抬高型心肌梗死(STEMI)和急性非ST段抬高型心肌梗死(NSTEMI)分别为59.1%、40.9%；STEMI患者较NSTEMI患者发病平均年龄低，分别为(67.72±12.80)岁、(62.05±13.42)岁，差异有统计学意义(P<0.05)；急性心肌梗死患者院内总体病死率为9.4%，其中STEMI占63.1%，NSTEMI占36.9%；多因素回归分析结果显示，高龄、吸烟、心衰、心源性休克、出血事件是急性心肌梗死患者院内死亡的危险因素(P<0.05)。结论 登封市急性心肌梗死患者发病人数逐年增加，其中以男性多发，老年患者病死率较高，AMI患者住院病死逐年下降，手术患者比例逐年升高，高龄、吸烟、心衰、心源性休克、出血事件为急性心肌梗死患者院内死亡的独立危险因素。
      【关键词】 登封市；急性心肌梗死；临床特点；病死率；危险因素
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2019）18—2322—05

Changing trend of clinical characteristics and risk factors for in-hospital death on acute myocardial infarction inDengfeng in 2009-2018.
REN Yi-hui, GUO Xing-hua, HE Xiao-wu, YAN Jian-li, SONG Xiao-ping, WANG Xiao-fei,ZHAN Ji-bin, GUO Xiao-wei, FAN Li-yuan, GENG Hong-xu. Department of Cardiology, Dengfeng People’s Hospital,Dengfeng 452470, Henan, CHINA
【Abstract】 Objective To investigate the Changing trend of clinical characteristics and risk factors for in-hospi-tal death on acute myocardial infarction in Dengfeng during 2009—2018. Methods The clinical data of 1 496 patientswith acute myocardial infarction admitted to Dengfeng People's Hospital from January 1, 2009 to December 28, 2018were retrospectively analyzed. The total number, age, gender, clinical symptoms and characteristics, types of myocardialinfarction, treatment methods and prognosis during hospitalization were analyzed. Results Among the 1 496 patients,the mean age was 64.37±13.46; 70.0% suffered from hypertension or increased blood pressure on admission; the male/fe-male ratio was 2.07 to 1; 59.1% were identified as ST segment elevation acute myocardial infarction (STEMI) and40.9% as non-ST segment elevation acute myocardial infarction (NSTEMI). The average age of onset in patients withSTEMI was (67.72±12.80) years old as compared with (62.05±13.42) years old in patients with NSTEMI (P<0.05); theoverall hospital mortality of AMI was 9.4% (63.1% for STEMI, 36.9% for NSTEMI). Multivariate regression analysisshowed that age, smoking, heart failure, cardiogenic shock, and hemorrhagic events were risk factors for hospital mortali-ty in patients with AMI (all P<0.05). Conclusion The number of patients with AMI in Dengfeng city is increasing yearby year, among which males have higher incidence than females, and the mortality rate of elderly patients is higher. Themortality of AMI patients in hospital is decreasing year by year, and the proportion of surgical patients is increasing yearby year. Age, smoking, heart failure, cardiogenic shock, and hemorrhage events are independent risk factors for in-hospi-tal mortality of AMI.
      【Key words】 Dengfeng; Acute myocardial infarction; Clinical characteristics; Mortality; Risk factor