标题：急性心肌梗死致心脏破裂的影响因素分析

      作者：梁普博，袁月荣，郑云龙，苏丹霞，赵红娟    (广东省农垦中心医院心血管内科，广东 湛江 524002)

      卷次： 2016年27卷22期

      【摘要】 目的 探讨急性心肌梗死(AMI)患者发生心脏破裂(CR)的影响因素。方法 回顾性分析我院 2005年1月至2016年1月住院确诊的1 438例AMI患者临床资料，根据患者是否合并心脏破裂分为心脏破裂组(n=25)和对照组(n=1 413)，运用Logistic回归分析法分析AMI患者并发CR的可能影响因素。结果 心脏破裂组患者年龄、女性发生率、前壁梗死率、初发AMI发生率、收缩压、血肌酐均明显高于对照组，血红蛋白、红细胞压积、左心室射血分数及早期成功灌注率均低于对照组，差异均有统计学意义(P<0.05)；Logistic回归分析显示，高龄、女性、前壁梗死、合并高血压、贫血、早期未成功灌注、低红细胞压积是AMI患者发生CR的独立影响因素(P<0.05)。结论 AMI并发CR预后极差，其影响因素主要有高龄、女性、前壁梗死、合并高血压、贫血、早期未成功灌注、低红细胞压积等，应积极预防、早期诊断及早期成功再灌注治疗以减少CR的发生。
      【关键词】 急性心肌梗死；心脏破裂；影响因素
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2016）22—3622—03

Analysis on influence factors of cardiac rupture caused by acute myocardial infarction.
LIANG Pu-bo, YUANYue-rong, ZHENG Yun-long, SU Dan-xia, ZHAO Hong-juan. Cardiovascular Department, Guangdong AgribusinessCentral Hospital, Zhanjiang 524002, Guangdong, CHINA
【Abstract】 Objective To explore influence factors of cardiac rupture (CR) in patients with acute myocardial in-farction (AMI). Methods The clinical data of 1,438 patients with AMI who admitted in our hospital from January 2005to January 2016 were retrospectively reviewed. Patients were divided into CR group (25 cases with CR) and controlgroup (1,413 cases without CR). Logistic regression analysis was used to analyze the possible influencing factors of CRin patients with AMI. Results CR group were significantly higher than control group among age, the incidence of CRin females, the incidence of anterior infarction, the incidence of first AMI, systolic pressure and serum creatinine. CRgroup were significantly lower than control group in hemoglobin, hematokrit, left ventricular ejection fraction and suc-cessful early reperfusion, with statistically significant differences (P<0.05). Logistic regression analysis showed that old-er age, female, anterior infarction, complicated with hypertension, anemia, unsuccessful early perfusion and low hemato-crit levels were the independent influence factors of CR in patients with AMI. Conclusion The prognosis of AMI com-plicated with CR is poor, and the main influencing factors are older age, female, anterior infarction, complicated with hy-pertension, anemia, unsuccessful early perfusion, low hematocrit levels. Early diagnosis, active prevention and success-ful reperfusion could reduce the incidence of CR.
      【Key words】 Acute myocardial infarction (AMI); Cardiac rupture (CR); Influence factors·论 著·doi:10.3969/j.issn.1003-6350.2016.22.003基金项目：2016年度广东省湛江市非资助科技攻关计划项目(编号：2016B01155)